Implications of the Merit-Based Incentive Payment System for Urology Practices.
Implications of the Merit-Based Incentive Payment System for Urology Practices.
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DOI：
10.1016/j.urology.2022.05.052
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发表时间：
2022-11
期刊：
影响因子：
2.1
通讯作者：
Shahinian, Vahakn B.
中科院分区：
文献类型：
--
作者：
Maganty, Avinash;Hollenbeck, Brent K.;Kaufman, Samuel R.;Oerline, Mary K.;Lai, Lillian Y.;Caram, Megan E., V;Shahinian, Vahakn B.
确定基于绩效的奖励支付系统（MIPS）对泌尿外科实践的影响。MIPS是一种医疗保险支付模式，根据四个类别的表现确定医生是否受到经济处罚或获得奖金：质量，实践改进，促进互操作性和支出。我们使用医疗保险数据对2017年和2019年MIPS的泌尿科医生表现进行了横断面分析。泌尿科医生的实践组织被分类为单专业（小，中，大）或多专业组。MIPS评分由实践组织估计。Logistic回归模型被用来研究泌尿外科实践特征之间的关联，包括双重合格受益人的比例，和医疗保险方法定义的奖金支付调整。在2017年和2019年之间的合并率（从较小的实践到较大的实践）之间比较了那些在2017年受到惩罚的人和那些没有受到惩罚的人。小型诊所的泌尿科医生在MIPS中表现较差，与大型团体诊所相比，2017年和2019年获得奖金的调整后比值比显著较低（2017年比值比[OR] 0.04，95%置信区间[95%CI] 0.03-0.05，2019年OR 0.37，95%CI 0.30-0.47）。增加患者面板内的双重合格受益人的百分比与在两个绩效年度获得奖金的几率降低相关。2017年受到处罚的泌尿科医生到2019年的巩固率高于未受到处罚的泌尿科医生（14%对5%，p<0.05）。小型泌尿外科诊所和那些照顾更高比例的双重合格受益人的诊所在MIPS中的表现往往更差。
To determine the implications of the merit-based incentive payment system (MIPS) for urology practices. MIPS is a Medicare payment model that determines whether a physician is financially penalized or receives bonus payment based on performance in four categories: quality, practice improvement, promotion of interoperability, and spending. We performed a cross-sectional analysis of urologist performance in MIPS for 2017 and 2019 using Medicare data. Urologist practice organization was categorized as single-specialty (small, medium, large) or multispecialty groups. MIPS scores were estimated by practice organization. Logistic regression models were used to examine the association between urology practice characteristics, including proportion of dual eligible beneficiaries, and bonus payment adjustment as defined by Medicare methodology. Rates of consolidation (movement from smaller to larger practices) between 2017 and 2019 were compared between those who were and those who were not penalized in 2017. Urologists in small practices performed worse in MIPS and had a significantly lower adjusted odds ratio of receiving bonus payments in both 2017 and 2019 compared to larger group practices (odds ratio [OR] 0.04, 95% confidence interval [95%CI] 0.03–0.05 in 2017 and OR 0.37, 95%CI 0.30–0.47 in 2019). Increasing percent of dual eligible beneficiaries within a patient panel was associated with decreased odds of receiving bonus payment in both performance years. Urologists penalized in 2017 had higher rates of consolidation by 2019 compared to those who were not (14% vs. 5%, p<0.05). Small urology practices and those caring for a higher proportion of dual eligible beneficiaries tended to perform worse in MIPS.
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影响因子：
4.2
作者：
Cwalina, Thomas B.;Jella, Tarun K.;Kamath, Atul F.
通讯作者：
Kamath, Atul F.
DOI：
10.3909/riu0779
发表时间：
2017-01-01
期刊：
Reviews in urology
影响因子：
--
作者：
Kapoor, Deepak A;Shore, Neal D;Latino, Kathleen
通讯作者：
Latino, Kathleen
影响因子：
4.8
作者：
George S;Daniels K;Fioratou E
通讯作者：
Fioratou E
影响因子：
0.8
作者：
Modi PK;Yan P;Hollenbeck BK;Kaufman SR;Borza T;Skolarus TA;Schroeck FR;Ryan AM;Shahinian VB;Herrel LA
通讯作者：
Herrel LA
影响因子：
9.7
作者：
Roberts, Eric T.;Mehrotra, Ateev;McWilliams, J. Michael
通讯作者：
McWilliams, J. Michael