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The Hand Surgeon's Practice and the Evolving Merit-Based Incentive Payment System.

Jacqueline N Byrd¹, Kevin C Chung²

¹Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School, Ann Arbor, MI; Center for Health Outcomes and Policy, University of Michigan, Ann Arbor, MI; Department of Surgery, University of Texas Southwestern Medical School, Dallas, TX.

The Journal of Hand Surgery

|June 18, 2022

Summary

This summary is machine-generated.

The Merit-Based Incentive Payment System (MIPS) impacts physician payments, evolving with new measures and patient complexity considerations. Policy adjustments are needed to ensure vulnerable patients maintain access to care under this value-based program.

Keywords:

Hand surgeons policy provider reimbursement value-based care

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Area of Science:

Health Policy
Medical Economics
Healthcare Quality

Background:

The Merit-Based Incentive Payment System (MIPS) was implemented in 2017 to transition Medicare physician payments to a value-based model.
MIPS scoring began in 2017, with payment adjustments starting in 2019, and the program is subject to ongoing evolution.
Concerns exist regarding potential unintended consequences of MIPS on healthcare delivery and patient access.

Purpose of the Study:

To review the initial rollout of the MIPS program during its first performance year (2017).
To summarize key changes affecting MIPS payment adjustments for the 2022 performance year.
To highlight the necessity of policy informed by clinical experience to safeguard access for vulnerable patient populations.

Main Methods:

Review of MIPS program guidelines and policy updates.
Analysis of MIPS performance year data and scoring adjustments.
Synthesis of clinical experience to inform policy recommendations.

Main Results:

The MIPS program has undergone significant evolution since its inception in 2017.
Adjustments in measures, score weighting, and patient complexity are key features of MIPS evolution.
The review identifies critical changes impacting payment adjustments up to the 2022 performance year.

Conclusions:

Continued evolution of MIPS requires careful monitoring for unintended consequences.
Policy development must integrate clinical experience to ensure equitable access to care.
Protecting vulnerable patients is paramount amidst value-based payment program changes.