Performance of Internists and Medicine Specialists in Medicare Quality Metrics: Variation by Specialty and Other Physician Characteristics
As healthcare payments shift from volume- to value-based paradigms, Medicare’s Quality Payment Program (QPP) was established to accelerate that transition.1 Under QPP, most physicians will be scored and paid via the Merit-Based Incentive Payment System (MIPS). MIPS provides a wide range of quality measures for various medical specialties, and its various reporting options include traditional claims-based as well as registry-based and qualified clinical data registry (QCDR)-based reporting mechanisms.
Physicians’ performance variation under such measures is currently not well understood. For example, it remains unknown whether available measures favor or disfavor certain specialties in obtaining high scores and therefore positive payment adjustments in MIPS. Understanding how various specialty groups have performed to date could help inform the Centers for Medicare & Medicaid Services (CMS) and professional societies as they jointly develop and implement meaningful and fair...
KEY WORDSperformance measurement quality assessment Medicare health policy
Drs. Rosenkrantz and Duszak are supported by research grants from the Harvey L. Neiman Health Policy Institute.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they do not have a conflict of interest.
- 1.Centers for Medicare & Medicaid Services. Quality Payment Program. https://qpp.cms.gov/. Accessed on July 18, 2018.
- 2.Centers for Medicare & Medicaid Serivces. Physician Compare 2015 Individual EP public reporting. https://data.medicare.gov/Physician-Compare/Physician-Compare-2016-Individual-EP-Public-Report/5qwk-yzai/data. Accessed on July 18, 2018.
- 3.Centers for Medicare & Medicaid Services. Physician Compare National Downloadable File. https://data.medicare.gov/Physician-Compare/Physician-Compare-National-Downloadable-File/mj5m-pzi6. Accessed on July 18, 2018.
- 5.Medicare Payment Advisory Commission. Report to the Congressl Medicare Payment Policy. Chapter 15. March 2018. http://www.medpac.gov/docs/default-source/reports/mar18_medpac_entirereport_sec.pdf? Accessd on July 18, 2018.