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
- 来源:
- 关键词:AdherenceAdoptedAffectCancer EtiologyCaringCategoriesCessation of lifeClinicalCost efficiencyDataDiagnosisDiagnostic testsDiseaseExposure toFee-for-Service PlansFutureGuidelinesHealthHealth Services AccessibilityHealthcareIncentivesInformation TechnologyInterruptionInterventionKnowledgeLeadLightLinkMagnetic Resonance ImagingMalignant NeoplasmsMalignant neoplasm of prostateMeasuresMedicareMedicare claimMedicare/MedicaidMethodsModelingMonitorMotivationNewly DiagnosedOutcomePSA screeningPatient CarePatientsPerformancePhysiciansPoliciesPopulationPriceProstateQuality of CareReportingRiskSeriesStandardizationSystemTimeUncertaintyUnited StatesVariantVisitVulnerable PopulationsWeightWorkadverse outcomebasebeneficiarycancer carecare costscare deliverycostdesigndual eligibleeconometricsfinancial incentivehigh riskimprovedmenmortalitypaymentprogramsprostate biopsyprovider behaviorsocialsuccesstumor progressionvirtual
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.
项目总结
前列腺癌是美国男性癌症死亡的第二大原因。它
仍然是一种具有挑战性的疾病,因为许多男性并不能立即受益
治疗,要么是由于疾病进展缓慢,要么是由于相互竞争的风险。这种不确定性是否会
什么时候治疗导致前列腺癌的治疗有很大的不同,
我们已经证明,这是由非临床因素推动的,比如经济激励。按以下方式收费-
服务支付模式提供了使用激励,但这可能并不总是带来以下好处
患者,在某些情况下可能是有害的。因此,设计预付款模式
通过提高质量和减少支出来实现高价值的医疗保健至关重要。
收费医疗保险中的基于功绩的激励支付系统(MIPS),作为
联邦医疗保险接入和芯片重新授权法案是一种支付模式,旨在改善
通过跟踪质量措施和监控支出来实现护理价值。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机会
至关重要。随着联邦医疗保险每年增加支出部分的权重,支出是
在决定项目成功与否方面变得越来越重要。然而,激励措施
减少开支可能并不总是与高质量的医疗保健相一致。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,以避免
弱势人群,他们与最高的护理费用和更严重的癌症有关
结果,以改善其在方案内的表现。鉴于此,理解
该政策对弱势群体的护理质量和获得机会的影响至关重要。
使用链接到医生质量报告文件的全国Medicare索赔数据,我们将确定
MIPS采用的方法对前列腺癌护理质量和可获得性的影响
计量经济学。我们将具体评估该政策对大多数人获得医疗保险的影响
弱势群体,双重符合条件的受益人。我们的研究结果将提高我们的
了解MIPS可能如何影响前列腺癌患者的护理,以及它是否
促进在提供护理方面的不平等。这项研究的发现将直接告诉我们
政策制定者了解计划中的潜在差距,以便在未来的迭代中可能会改进政策
加强对病人的护理。
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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