Hayden Richard, Coffin Janis
J Med Pract Manage. 2016 Nov;32(3):173-176.
The passage of the Medicare Access and CHIP Reauthorization Act in Apri 2015 set the stage for the Part B reimbursement changes set to take place in 2019 based on the 2017 reporting period in relation to performance within core Medicare initiatives through the Merit-Based Incentive Payment System (MIPS) These changes will reflect the new "fee-for-performance" approach to reimbursements through individualized changes to an individual or practice group's conversion factor used in the RVU reimbursement calculation. The metrics being used as a basis for eligible provider competitive ranking for either positive or negative reimbursement changes are in proportion to performance on chosen Physician Quality Reporting System measures, value-based payment modifier calculations, compliance with Modified Stage 2 or Stage 3 Meaningful Use as part of the Electronic Health Record Incentive Program, and ongoing participation in clinical practice improvement activities. This article describes the core elements that make up MIPS and discusses the likely criteria that will be used as the core elements necessary for competitive reimbursement rankinq.
2015年4月《医疗保险准入与儿童健康保险计划再授权法案》的通过，为2019年基于2017年报告期的B部分报销变更奠定了基础，这些变更是通过基于绩效的激励支付系统（MIPS）在核心医疗保险计划中的表现来实现的。这些变化将反映新的“绩效付费”报销方式，即通过对个人或执业团体在相对价值单位（RVU）报销计算中使用的转换因子进行个性化更改来实现。作为 eligible provider 进行正或负报销变更的竞争性排名基础的指标，与在选定的医师质量报告系统指标上的表现、基于价值的支付调整因子计算、作为电子健康记录激励计划一部分的符合修改后的第2阶段或第3阶段有意义使用标准以及持续参与临床实践改进活动成比例。本文描述了构成MIPS的核心要素，并讨论了可能用作竞争性报销排名所需核心要素的标准。 （注：原文中“eligible provider”表述不太准确，可能是“参与该计划的提供者”之类的意思，需结合更多背景信息准确理解。）
