Department of Radiology, NYU Langone Medical Center, New York, New York.
Department of Radiology, NYU Langone Medical Center, New York, New York.
J Am Coll Radiol. 2018 Apr;15(4):674-680. doi: 10.1016/j.jacr.2017.11.009. Epub 2017 Dec 15.
To optimize the flexibility and relevancy of its Merit-Based Incentive Payment System (MIPS), CMS exempts selected physicians and groups from participation and grants others relaxed reporting requirements. We assess the practical implications of such special status determinations.
For a random sample of 1,000 Medicare-participating radiologists, the CMS MIPS Participation Lookup Tool was manually searched. Individual radiologists' and associated groups' participation requirements and special statuses were assessed.
Although only 55% of radiologists were required to participate in MIPS as individuals when considering only one associated taxpayer identification number (TIN), 83% were required to participate as individuals when considering all associated TINs. When using the group reporting option, 97% of radiology groups were required to participate. High participation requirements persisted across generalist and subspecialist radiologists, small and rural, and both academic and nonacademic practices. Non-patient-facing and hospital-based statuses were assigned to high fractions of individual radiologists (91% and 71%, respectively), but much lower fractions of group practices (72% and 25%). Rural and health professional shortage area statuses were assigned to higher percentages of groups (27% and 39%) than individuals (13% and 23%). Small practice status was assigned to 22% of individuals versus 16% of groups.
Although not apparent if only considering individual radiologist-TIN combinations, the overwhelming majority of radiologists will be required to participate in MIPS, at the individual or group level. Radiology groups are strongly encouraged to review their physicians' MIPS participation requirements and special statuses to ensure optimal performance scores and payment bonuses.
为了优化其基于绩效的激励支付系统（MIPS）的灵活性和相关性，CMS 将部分医师和团体排除在参与之外，并给予其他团体更宽松的报告要求。我们评估了这种特殊地位确定的实际影响。
对 1000 名参与 Medicare 的放射科医师进行随机抽样，使用 CMS 的 MIPS 参与查询工具进行手动搜索。评估了个别放射科医师及其相关团体的参与要求和特殊地位。
尽管仅考虑一个相关纳税人识别号码（TIN）时，只有 55%的放射科医师被要求作为个人参与 MIPS，但考虑所有相关 TIN 时，83%的放射科医师被要求作为个人参与。当使用团体报告选项时，97%的放射科团体需要参与。高参与要求在普通科和亚专科放射科医师、小和农村、学术和非学术实践中都存在。非患者为中心和医院为基础的地位被分配给了大量的个人放射科医师（分别为 91%和 71%），但团体实践中的比例要低得多（分别为 72%和 25%）。农村和卫生专业短缺地区的地位被分配给团体的比例（分别为 27%和 39%）高于个人（分别为 13%和 23%）。小实践地位被分配给 22%的个人，而不是 16%的团体。
尽管仅考虑个别放射科医师-TIN 组合时并不明显，但绝大多数放射科医师将需要以个人或团体的身份参与 MIPS。放射科团体强烈鼓励审查其医师的 MIPS 参与要求和特殊地位，以确保获得最佳绩效评分和支付奖金。
