Joshua M. Liao (
Judy A. Shea is a professor in the Department of Medicine and associate dean of medical education research, Perelman School of Medicine, and a senior fellow at the Leonard Davis Institute of Health Economics, University of Pennsylvania.
Health Aff (Millwood). 2018 Jul;37(7):1079-1086. doi: 10.1377/hlthaff.2017.1485.
We surveyed a national sample of internal medicine physicians in March-May 2017 to explore their beliefs about the newly implemented Merit-based Incentive Payment System (MIPS). Respondents believed that their efforts in the four focus areas identified in the survey would ultimately improve the value of care. When informed that those areas represented the four MIPS domains, the majority remained positive about the likely impact on value. However, expectations varied by physicians' characteristics and sense of control over the desired outcomes, and many respondents believed that unintended consequences could occur. Moreover, respondents generally reported low familiarity with the policy and disagreed with program guidelines for weighting domains in the composite score. These findings indicate the need to educate physicians about MIPS and suggest potentially fruitful approaches. Moving forward, policy makers should monitor for unintended consequences and explore ways to better align program guidelines with physicians' perspectives.
我们于 2017 年 3 月至 5 月调查了全国范围内的内科医生，以了解他们对新实施的基于绩效的激励支付系统（MIPS）的看法。受访者认为，他们在调查中确定的四个重点领域的努力最终将提高医疗保健的价值。当被告知这些领域代表 MIPS 的四个领域时，大多数人仍然对可能对价值产生的积极影响持乐观态度。然而，预期因医生的特征和对预期结果的控制感而有所不同，许多受访者认为可能会出现意想不到的后果。此外，受访者普遍报告称对该政策不太熟悉，并不同意综合评分中对域进行加权的方案准则。这些发现表明有必要对医生进行 MIPS 教育，并提出可能有成效的方法。展望未来，政策制定者应监测意外后果，并探索使方案准则与医生观点更好地保持一致的方法。
