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Merit-based Incentive Payment System (MIPS)
Clinical significance:
- MIPS affects reimbursement via penalties & bonuses for performance across several cost & quality measures, but does not affect clinical outcomes [3]
- better physician performance on the MIPS quality score associated with better hospital surgical outcomes for some physician specialties during 1st year of MIPS [2]
Notes:
- MACRA program
- focuses on 4 components
- quality
- cost/resource use
- clinical practice improvement
- advancing care measures for Medicare-enrolled practitioners
- supesedes the following eliminated programs:
- Physician Quality Reporting System
- Physician Value-based Payment Model
- Medicare Electronic Health Record Incentive Program
Related
Medicare Access & CHIP Reauthorization Act (MACRA)
General
reporting system
References
- Geriatric Review Syllabus, 10th edition (GRS10)
Harper GM, Lyons WL, Potter JF (eds)
American Geriatrics Society, 2019
- Glance LG, Thirukumaran CP, Feng C et al
Association Between the Physician Quality Score in the Merit-Based
Incentive Payment System and Hospital Performance in Hospital Compare
in the First Year of the Program.
JAMA Netw Open. 2021;4(8):e2118449.
PMID: 34342653 PMCID: PMC8335582 Free PMC article
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2782631
- Bond AM et al.
Association between individual primary care physician merit-based incentive
payment system score and measures of process and patient outcomes.
JAMA 2022 Dec 6; 328:2136-2146.
PMID: 36472595
https://jamanetwork.com/journals/jama/fullarticle/2799153
- McWilliams JM.
Pay for performance: When slogans overtake science in health policy.
JAMA 2022 Dec 6; 328:2114-2116.
PMID: 36472613
https://jamanetwork.com/journals/jama/fullarticle/2799177
- The Quality Improvement Program: MIPS overview.
https://qpp.cms.gov/mips/overview
Component-of
Medicare Access & CHIP Reauthorization Act (MACRA)