Urologist Scores in the Era of the Merit-Based Incentive Payment System (MIPS)

Alam, Ridwan; Clifton, Marisa M.; Han, Misop

doi:10.1097/upj.0000000000000285

Cited by 2 publications

(1 citation statement)

References 17 publications

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“…Other variables that were positively associated with MIPS performance included participation in MIPS as a physician group or APM and average HCC risk score of beneficiaries. The positive association between group or APM participation and performance has been extensively reported across multiple specialties, 31-37 including neurosurgery 25 ; this finding may be related to APM practices having improved infrastructure and resources for collecting and reporting performance measures. 18 The positive association between HCC risk score and performance may be partly explained by the incorporation of risk adjustment measures in later years of the program, such as the inclusion of the risk-adjusted cost subscore in 2018 and 2019 and the introduction of the CPB in 2020.…”

Section: Discussionmentioning

confidence: 82%

Performance of Neurosurgeons Providing Safety-Net Care Under Medicare's Merit-Based Incentive Payment System

Ng,

DiGiorgio

2024

Neurosurgery

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BACKGROUND AND OBJECTIVES: Under the Merit-Based Incentive Payment System (MIPS), Medicare evaluates provider performance to determine payment adjustments. Studies examining the first year of MIPS (2017) showed that safety-net providers had lower MIPS scores, but the performance of safety-net physicians over time has not been studied. This study aimed to examine the performance of safety-net vs non–safety-net neurosurgeons in MIPS from 2017 to 2020. METHODS: Safety-net neurosurgeons were defined as being in the top quartile according to proportion of dual-eligible beneficiaries and non–safety-net in the bottom quartile. Outcomes were total MIPS scores and dual-eligible proportion over time. In this descriptive study, we evaluated ordinary least squares regression models with SEs clustered at the physician level. Covariates of interest included safety-net status, year, and average Hierarchical Condition Category risk score of beneficiaries. RESULTS: There were 2796–3322 physicians included each year between 2017 and 2020. Mean total MIPS scores were not significantly different for safety-net than non–safety-net physicians in 2017 but were greater for safety-net in 2018 (90.7 vs 84.5, P < .01), 2019 (86.4 vs 81.5, P < .01), and 2020 (90.9 vs 86.7, P < .01). Safety-net status (coefficient −9.11; 95% CI [−13.15, −5.07]; P < .01) and participation in MIPS as an individual (−9.89; [−12.66, −7.13]; P < .01) were associated with lower scores while year, the interaction between safety-net status and year, and participation in MIPS as a physician group or alternative payment model were associated with higher scores. Average Hierarchical Condition Category risk score of beneficiaries (−.011; [−.015, −.006]; P < .01) was associated with decreasing dual-eligible case mix, whereas average age of beneficiaries (.002; [.002, .003]; P < .01) was associated with increasing dual-eligible case mix. CONCLUSION: Being a safety-net physician was associated with lower MIPS scores, but safety-net neurosurgeons demonstrated greater improvement in MIPS scores than non–safety-net neurosurgeons over time. Providers with higher-risk patients were more likely to decrease their dual-eligible case mix over time.

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Section: Discussionmentioning

confidence: 82%