Gettel Cameron J, Tinloy Bradford, Nedza Susan M, Granovsky Michael A, Goyal Pawan, Terry Aisha T, Venkatesh Arjun K
Department of Emergency Medicine Yale School of Medicine New Haven Connecticut USA.
National Clinician Scholars Program Department of Internal Medicine Yale School of Medicine New Haven Connecticut USA.
J Am Coll Emerg Physicians Open. 2022 Mar 12;3(2):e12672. doi: 10.1002/emp2.12672. eCollection 2022 Apr.
The Centers for Medicare & Medicaid Services (CMS) implemented the Merit-based Incentive Payment System (MIPS) to accelerate the transition of physician payment toward value-based care models and away from traditional fee-for-service payment programs. In recent years, CMS has sought to modify the program by developing a MIPS Value Pathway (MVP) framework intended to use existing and future physician quality and cost measures to reward value-based care delivery. This article describes the multi-step process of the MVP Task Force, convened by the American College of Emergency Physicians (ACEP) to develop an emergency medicine-specific MVP proposal informed by diverse stakeholder perceptions regarding: (1) which existing quality measures reflect high quality emergency care, and (2) the degree to which emergency clinicians can impact clinical outcomes and cost for the care domains captured by existing quality measures. The MVP Task Force synthesized stakeholder feedback and underwent a consensus-building approach to develop the "Adopting Best Practices and Promoting Patient Safety within Emergency Medicine" MVP, recently reviewed and approved by CMS for national implementation starting in 2023. Our process and findings have broad implications for clinicians, administrators, and policymakers navigating the continued transition to value-based care in conjunction with CMS's implementation of the MVP framework.
医疗保险和医疗补助服务中心（CMS）实施了基于绩效的激励支付系统（MIPS），以加速医生支付方式从传统的按服务收费支付计划向基于价值的医疗模式转变。近年来，CMS试图通过制定MIPS价值路径（MVP）框架来修改该计划，该框架旨在利用现有和未来的医生质量和成本衡量指标来奖励基于价值的医疗服务提供。本文描述了由美国急诊医师学会（ACEP）召集的MVP特别工作组的多步骤过程，该工作组旨在根据不同利益相关者对以下方面的看法制定一份针对急诊医学的MVP提案：（1）哪些现有质量衡量指标反映了高质量的急诊护理，以及（2）急诊临床医生能够在多大程度上影响现有质量衡量指标所涵盖的护理领域的临床结果和成本。MVP特别工作组综合了利益相关者的反馈，并采用了建立共识的方法来制定“在急诊医学中采用最佳实践和促进患者安全”的MVP，该提案最近已由CMS审查并批准，将于2023年开始在全国实施。我们的过程和发现对于临床医生、管理人员和政策制定者在与CMS实施MVP框架相结合的情况下继续向基于价值的医疗过渡具有广泛的意义。
