肿瘤学家在基于绩效的激励支付制度中的参与和表现。
Oncologist Participation and Performance in the Merit-Based Incentive Payment System.
机构信息
Dell Medical School, The University of Texas at Austin, Austin, TX, USA.
Case Western Reserve University School of Medicine, Cleveland, OH, USA.
出版信息
Oncologist. 2023 Apr 6;28(4):e228-e232. doi: 10.1093/oncolo/oyad033.
The 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.
基于绩效的激励支付系统（MIPS）是由医疗保险和医疗补助服务中心（CMS）创建的一种基于价值的支付模式，旨在通过对医疗保险报销的基于绩效的调整来促进高价值的医疗服务。在这项横断面研究中，我们研究了 2019 年 MIPS 中肿瘤学家的参与情况和表现。与所有专科医生的参与率（97%）相比，肿瘤学家的参与率较低（86%）。在调整实践特征后，我们发现采用替代支付模式（APM）作为申报来源的肿瘤学家的 MIPS 评分较高（APM 组的平均得分为 91，个人组为 77.6；差异为 13.41[95%CI，12.21，14.6]），这表明参与者需要更多的组织资源。得分较低与患者病情更复杂有关（得分最高的五分位数组为 83.4，得分最低的五分位数组为 84.9，差异为-1.43[95%CI，-2.48，-0.37]），这表明 CMS 需要更好地进行风险调整。我们的研究结果可能为未来改善肿瘤学家参与 MIPS 的努力提供指导。
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