Impact of the Merit-Based Incentive Payment System on the Quality of Prostate Cancer Care

绩效奖励制度对前列腺癌护理质量的影响

基本信息

  • 批准号:
    10535234
  • 负责人:
  • 金额:
    $ 8.56万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2022
  • 资助国家:
    美国
  • 起止时间:
    2022-07-15 至 2023-07-14
  • 项目状态:
    已结题

项目摘要

PROJECT SUMMARY Prostate cancer is the second leading cause of cancer death among men in the United States. It remains a challenging disease to treat given that many men do not benefit from immediate treatment, either due to slow-progressing disease or competing risks. This uncertainty about whether and when to treat has resulted in considerable variation in the management of prostate cancer, which we have shown to be driven by non-clinical factors such as financial incentives. Fee-for- service payment models provide incentives for utilization, but this may not always lead to benefits for patients, and in some instances can be harmful. Therefore, designing payment models that advance high-value healthcare by promoting both quality and reduced spending is critical. The Merit-Based Incentive Payment System (MIPS) in fee-for-service Medicare, introduced as part of the Medicare Access and CHIP Reauthorization Act, is a payment model that aims to improve the value of care by tracking quality measures and monitoring spending. Understanding how motivations to reduce spending implied by the MIPS policy affect quality and access to prostate cancer care is crucial. As Medicare annually escalates the weight of the spending component, spending is becoming increasingly important in determining success within the program. However, incentives to reduce spending may not always align with quality care. Additionally, incentives to reduce spending may have unintended consequences. For example, physicians may be influenced to avoid vulnerable populations, who are associated with the highest cost of care and worse cancer outcomes, in order to improve their performance within the program. In light of this, understanding the impact of the policy on quality of care and access for vulnerable populations is crucial. Using national Medicare claims data linked to physician quality reporting files, we will identify the impact of MIPS on quality and access to prostate cancer care utilizing methods adopted from econometrics. We will specifically assess the policy’s impact on access to care for Medicare’s most vulnerable population, dual eligible beneficiaries. The results of our study will enhance our understanding of how MIPS may influence care for men with prostate cancer and whether it promotes inequities in the delivery of care. The findings from this study will directly inform policymakers of potential gaps within the program so the policy may be improved in future iterations to enhance patient care.
项目概要 前列腺癌是美国男性癌症死亡的第二大原因。它 鉴于许多男性无法立即受益,因此仍然是一种难以治疗的疾病 由于疾病进展缓慢或竞争风险而无法接受治疗。这种不确定性是否 何时治疗导致前列腺癌的治疗存在很大差异, 我们已经证明这是由经济激励等非临床因素驱动的。收费- 服务付费模式提供了使用激励,但这可能并不总能带来好处 患者,并且在某些情况下可能是有害的。因此,设计能够推进的支付模式 通过提高质量和减少支出来实现高价值医疗保健至关重要。 按服务收费的医疗保险中基于绩效的激励支付系统 (MIPS),作为一部分引入 医疗保险准入和 CHIP 再授权法案的一部分,是一种支付模式,旨在改善 通过跟踪质量措施和监控支出来体现护理价值。了解动机如何 减少 MIPS 政策所暗示的支出会影响前列腺癌护理的质量和获取机会 至关重要的。随着医疗保险每年增加支出部分的权重,支出正在 在决定项目成功方面变得越来越重要。然而,激励措施 减少支出可能并不总是与优质护理相一致。此外,减少支出的激励措施 可能会产生意想不到的后果。例如,医生可能会受到影响而避免 弱势群体,他们的护理费用最高,癌症更严重 结果,以提高他们在计划中的表现。有鉴于此,了解 该政策对弱势群体的护理质量和获得服务的影响至关重要。 使用与医生质量报告文件相关联的国家医疗保险索赔数据,我们将确定 MIPS 采用的方法对前列腺癌护理的质量和可及性的影响 计量经济学。我们将专门评估该政策对 Medicare 大部分成员获得医疗服务的影响 弱势群体,双重合格受益人。我们的研究结果将增强我们 了解 MIPS 如何影响前列腺癌男性的护理以及是否 促进护理服务的不平等。这项研究的结果将直接告知 政策制定者了解计划中的潜在差距,以便在未来的迭代中改进政策 以加强患者护理。

项目成果

期刊论文数量(2)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Merit-based Incentive Payment System Quality Reporting in Urology Practices.
泌尿外科实践中基于绩效的激励支付系统质量报告。
  • DOI:
    10.1097/upj.0000000000000392
  • 发表时间:
    2023
  • 期刊:
  • 影响因子:
    0.8
  • 作者:
    Maganty,Avinash;Krampe,Noah;Shah,AnupA;Golla,Vishnukamal
  • 通讯作者:
    Golla,Vishnukamal
Re: Implementation and Assessment of No Opioid Prescription Strategy at Discharge After Major Urologic Cancer Surgery.
回复:重大泌尿系统癌症手术后出院时无阿片类药物处方策略的实施和评估。
  • DOI:
    10.1016/j.eururo.2023.03.012
  • 发表时间:
    2023
  • 期刊:
  • 影响因子:
    23.4
  • 作者:
    Maganty,Avinash;Williams,StephenB
  • 通讯作者:
    Williams,StephenB
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Avinash Maganty其他文献

Avinash Maganty的其他文献

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