Merit-Based Incentive Payment System: How Are Plastic Surgeons Performing?

Area of Science:

• Plastic Surgery
• Health Policy
• Healthcare Economics

Background:

• The Merit-based Incentive Payment System (MIPS) incentivizes high-value care through Medicare reimbursement adjustments.
• Higher MIPS scores correlate with better quality, efficiency, and interoperability, potentially offering financial benefits.
• Limited research exists on plastic surgery performance within MIPS.

Purpose of the Study:

• To characterize the performance of plastic surgeons in the Merit-based Incentive Payment System (MIPS).
• To identify factors associated with exceptional performance and bonus payments in MIPS for plastic surgeons.

Main Methods:

• Data from the Centers for Medicare and Medicaid Services (CMS) for plastic surgeons (2019-2021) were analyzed.
• Descriptive statistics and multivariable logistic regression identified predictors of bonus payment.
• Analysis focused on MIPS performance metrics, beneficiary characteristics, and reporting schemas.

Main Results:

• Total MIPS scores increased from 2019 to 2021, but quality scores decreased.
• Fewer physicians received positive adjustments and bonus payments in later years.
• Key predictors for bonus payments included alternative payment models, larger practice size, and a specific proportion of dual-eligible beneficiaries.

Conclusions:

• Understanding plastic surgeon performance in MIPS is crucial for policy development.
• Ensuring high-quality care translates to improved patient outcomes across diverse populations is essential.
• This analysis provides insights into MIPS participation and outcomes for plastic surgeons.