PMID- 35030565
OWN - NLM
STAT- MEDLINE
DCOM- 20220210
LR  - 20230821
IS  - 1537-1948 (Electronic)
IS  - 0025-7079 (Print)
IS  - 0025-7079 (Linking)
VI  - 60
IP  - 2
DP  - 2022 Feb 1
TI  - The 2018 Merit-based Incentive Payment System: Participation, Performance, and 
      Payment Across Specialties.
PG  - 156-163
LID - 10.1097/MLR.0000000000001674 [doi]
AB  - 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.
CI  - Copyright (c) 2022 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Gettel, Cameron J
AU  - Gettel CJ
AD  - Department of Emergency Medicine.
AD  - National Clinician Scholars Program, Department of Internal Medicine, Yale School 
      of Medicine.
FAU - Han, Christopher R
AU  - Han CR
AD  - Yale School of Medicine.
FAU - Canavan, Maureen E
AU  - Canavan ME
AD  - Department of Internal Medicine, Cancer Outcomes and Public Policy and 
      Effectiveness Research (COPPER).
FAU - Bernheim, Susannah M
AU  - Bernheim SM
AD  - Center for Outcomes Research and Evaluation.
AD  - Section of General Internal Medicine.
FAU - Drye, Elizabeth E
AU  - Drye EE
AD  - Center for Outcomes Research and Evaluation.
AD  - Department of Pediatrics, Yale School of Medicine, New Haven, CT.
FAU - Duseja, Reena
AU  - Duseja R
AD  - Office of Management and Budget, Washington, DC.
FAU - Venkatesh, Arjun K
AU  - Venkatesh AK
AD  - Department of Emergency Medicine.
AD  - Center for Outcomes Research and Evaluation.
LA  - eng
GR  - KL2 TR000140/TR/NCATS NIH HHS/United States
GR  - TL1 TR001864/TR/NCATS NIH HHS/United States
GR  - UL1 TR001863/TR/NCATS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Med Care
JT  - Medical care
JID - 0230027
SB  - IM
MH  - Cross-Sectional Studies
MH  - Humans
MH  - Medicare/*statistics & numerical data
MH  - Motivation
MH  - Quality Indicators, Health Care/*statistics & numerical data
MH  - Quality of Health Care
MH  - Reimbursement, Incentive/*statistics & numerical data
MH  - United States
PMC - PMC8820355
MID - NIHMS1756822
COIS- A.K.V. serves on the Clinical Emergency Data Registry (CEDR) Committee and within 
      several other quality measurement related roles in the American College of 
      Emergency Physicians. A.K.V. is also supported by the Moore Foundation, the 
      American College of Emergency Physicians, the American College of Radiology, and 
      the Foundation for Opioid Response Efforts for work developing quality measures 
      or programs such as the Emergency Quality Network intended to be used for CMS 
      MIPS Program participation. A.K.V., S.M.B., and E.E.D. also receive support for 
      contracted work from the Centers for Medicare and Medicaid Services to develop 
      hospital and health care outcome and efficiency quality measures and rating 
      systems. The remaining authors declare no conflict of interest.
EDAT- 2022/01/15 06:00
MHDA- 2022/02/11 06:00
PMCR- 2023/02/01
CRDT- 2022/01/14 20:22
PHST- 2022/01/14 20:22 [entrez]
PHST- 2022/01/15 06:00 [pubmed]
PHST- 2022/02/11 06:00 [medline]
PHST- 2023/02/01 00:00 [pmc-release]
AID - 00005650-202202000-00009 [pii]
AID - 10.1097/MLR.0000000000001674 [doi]
PST - ppublish
SO  - Med Care. 2022 Feb 1;60(2):156-163. doi: 10.1097/MLR.0000000000001674.