The 2018 Merit-based Incentive Payment System

Participation, Performance, and Payment Across Specialties

Datos Bibliográficos

ID9100337
AutoresCameron J Gettel (0000-0002-6249-1023, Department of Emergency Medicine, autor de correspondencia), Christopher R Han (Yale School of Medicine), Christopher Han (Yale University), Maureen Canavan (0000-0001-9410-3542), Maureen E Canavan (Department of Internal Medicine, Cancer Outcomes and Public Policy and Effectiveness Research (COPPER)), Susannah M Bernheim (0000-0001-5651-9694, Center for Outcomes Research and Evaluation), Elizabeth E Drye (0009-0006-9687-6075, Center for Outcomes Research and Evaluation), Reena Duseja (Office of Management and Budget, Washington, DC, autor de correspondencia), Alladi Venkatesh (0000-0002-8248-0567, Center for Outcomes Research and Clinical Epidemiology, autor de correspondencia), Arjun K Venkatesh (Department of Emergency Medicine)
Año2022
Volumen60
Número2
Páginas156-163
Fecha de publicación2022-02-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaMedical Care (JOURNAL)
Identificadores de la revistaISSN: 0025-7079 • E-ISSN: 1537-1948
EditorialOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000001674
PMID35030565
OpenAlexW4206088057
IdiomaEN
Referencias citadas18

BACKGROUND: The Merit-based Incentive Payment System (MIPS) incorporates financial incentives and penalties intended to drive clinicians towards value-based purchasing, including alternative payment models (APMs). Newly available Medicare-approved qualified clinical data registries (QCDRs) offer specialty-specific quality measures for clinician reporting, yet their impact on clinician performance and payment adjustments remains unknown. OBJECTIVES: We sought to characterize clinician participation, performance, and payment adjustments in the MIPS program across specialties, with a focus on clinician use of QCDRs. RESEARCH DESIGN: We performed a cross-sectional analysis of the 2018 MIPS program. RESULTS: During the 2018 performance year, 558,296 clinicians participated in the MIPS program across the 35 specialties assessed. Clinicians reporting as individuals had lower overall MIPS performance scores (median [interquartile range (IQR)], 80.0 [39.4-98.4] points) than those reporting as groups (median [IQR], 96.3 [76.9-100.0] points), who in turn had lower adjustments than clinicians reporting within MIPS APMs (median [IQR], 100.0 [100.0-100.0] points) (P<0.001). Clinicians reporting as individuals had lower payment adjustments (median [IQR], +0.7% [0.1%-1.6%]) than those reporting as groups (median [IQR], +1.5% [0.6%-1.7%]), who in turn had lower adjustments than clinicians reporting within MIPS APMs (median [IQR], +1.7% [1.7%-1.7%]) (P<0.001). Within a subpopulation of 202,685 clinicians across 12 specialties commonly using QCDRs, clinicians had overall MIPS performance scores and payment adjustments that were significantly greater if reporting at least 1 QCDR measure compared with those not reporting any QCDR measures. CONCLUSIONS: Collectively, these findings highlight that performance score and payment adjustments varied by reporting affiliation and QCDR use in the 2018 MIPS

Business · Family medicine · Incentive · Interquartile range · Pay for performance · Payment · Specialty · Economic and Financial Impacts of Cancer · Finance · Healthcare Policy and Management · Internal Medicine · Medicine · Primary Care and Health Outcomes