Oncologist Participation and Performance in the Merit-Based Incentive Payment System

Author:

Patel Vishal R1ORCID,Cwalina Thomas B2,Gupta Arjun3,Nortjé Nico4,Mullangi Samyukta5,Parikh Ravi B67,Shih Ya-Chen Tina8ORCID,Hussaini S M Qasim9

Affiliation:

1. Dell Medical School, The University of Texas at Austin , Austin, TX , USA

2. Case Western Reserve University School of Medicine , Cleveland, OH , USA

3. Division of Hematology, Oncology and Transplantation, Department of Medicine, Masonic Cancer Center, University of Minnesota , MN , USA

4. Section of Clinical Ethics, Department of Critical Care Medicine, The University of Texas MD Anderson Cancer Center , Houston, TX , USA

5. Department of Medicine, Memorial Sloan Kettering Cancer Center , New York, NY , USA

6. Penn Center for Cancer Care Innovation, Abramson Cancer Center, University of Pennsylvania , Philadelphia, PA , USA

7. Department of Medicine, Perelman School of Medicine, University of Pennsylvania , PA , USA

8. Section of Cancer Economics and Policy, Department of Health Services Research, The University of Texas MD Anderson Cancer Center , Houston, TX , USA

9. Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Medicine , Baltimore, MD , USA

Abstract

AbstractThe merit-based incentive payment system (MIPS) is a value-based payment model created by the Centers for Medicare & Medicaid Services (CMS) to promote high-value care through performance-based adjustments of Medicare reimbursements. In this cross-sectional study, we examined the participation and performance of oncologists in the 2019 MIPS. Oncologist participation was low (86%) compared to all-specialty participation (97%). After adjusting for practice characteristics, higher MIPS scores were observed among oncologists with alternative payment models (APMs) as their filing source (mean score, 91 for APMs vs. 77.6 for individuals; difference, 13.41 [95% CI, 12.21, 14.6]), indicating the importance of greater organizational resources for participants. Lower scores were associated with greater patient complexity (mean score, 83.4 for highest quintile vs. 84.9 for lowest quintile, difference, −1.43 [95% CI, −2.48, −0.37]), suggesting the need for better risk-adjustment by CMS. Our findings may guide future efforts to improve oncologist engagement in MIPS.

Publisher

Oxford University Press (OUP)

Subject

Cancer Research,Oncology

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