Gronbeck Christian, Feng Hao
Both authors are affiliated with the Department of Dermatology, University of Connecticut, Farmington, Connecticut.
Dermatol Surg. 2023 Oct 1;49(10):932-937. doi: 10.1097/DSS.0000000000003876. Epub 2023 Jul 4.
The Merit-Based Incentive Payment System (MIPS) seeks to promote value-based care through quality-adjusted Medicare payments.
To assess 2020 MIPS performance and quality measure selection by Mohs surgeons.
Retrospective, cross-sectional review of Medicare Quality Payment Program and Part B billing data sets.
In 2020, 8,778 dermatologists and 2,148 Mohs surgeons received a MIPS score. Mohs surgeons primarily participated through groups (51.6%) or individuals (36.4%). Most of them (77.4%) received a final score enabling a positive payment adjustment in 2022, with a notable proportion (22.3%) being eligible for a neutral payment adjustment in the setting of COVID-19 exemptions. The members of the American College of Mohs Surgery were more likely to meet the exceptional performance threshold (71.5% vs 59.0%, p < .0001), as were Mohs surgeons with <15 years of experience (73.3% vs 54.8%, p < .0001). Measures related to dermatology or Mohs surgery were reported by most individuals (92.0%) and dermatology groups (90.4%), yet less frequently by multispecialty groups (5.9%).
Many Mohs surgeons exceeded the performance threshold and used dermatology- or Mohs-related quality measures in 2020. Further assessments correlating quality measures with patient outcomes are needed to better understand the utility and appropriateness of the current value-based payment system and guide further policies.
基于绩效的激励支付系统(MIPS)旨在通过质量调整后的医疗保险支付来促进基于价值的医疗服务。
评估2020年Mohs外科医生的MIPS表现和质量指标选择。
对医疗保险质量支付计划和B部分计费数据集进行回顾性横断面研究。
2020年,8778名皮肤科医生和2148名Mohs外科医生获得了MIPS评分。Mohs外科医生主要通过团体(51.6%)或个人(36.4%)参与。他们中的大多数(77.4%)获得了最终评分,从而在2022年实现了正向支付调整,在新冠疫情豁免的情况下,有相当比例(22.3%)符合中性支付调整条件。美国Mohs外科学会的成员更有可能达到卓越绩效阈值(71.5%对59.0%,p <.0001),经验少于15年的Mohs外科医生也是如此(73.3%对54.8%,p <.0001)。大多数个人(92.0%)和皮肤科团体(90.4%)报告了与皮肤科或Mohs手术相关的指标,但多专科团体报告的频率较低(5.9%)。
2020年,许多Mohs外科医生超过了绩效阈值,并使用了与皮肤科或Mohs相关的质量指标。需要进一步评估质量指标与患者结局之间的相关性,以更好地理解当前基于价值的支付系统的效用和适用性,并指导进一步的政策制定。