医院医生整合和基于价值的支付:MIPS的早期结果
Ngoc H Thai1,2, Brady Post2,3, Gary J Young2,4
1Bouve College of Health Sciences, Northeastern University.
Medical care
|September 22, 2023
概括
医院整合并没有显著改善医疗保险基于优点的激励支付系统 (MIPS) 质量表现. 这项研究发现,综合和独立医生实践之间的MIPS质量评分没有差异.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗保健管理的管理
- 以价值为基础的护理
背景情况:
- 医院与医生的整合通常是为了通过共享资源提高临床质量而促进的.
- 基于价值的计划,比如医疗保险基于优点的激励支付系统 (MIPS),旨在将财务奖励与临床质量联系起来.
- 综合实践可能会从这些以价值为基础的计划中受益.
研究的目的:
- 评估医院医生整合与MIPS计划中的表现之间的关联.
- 为了比较医院整合和独立医生实践之间的MIPS绩效指标.
主要方法:
- 使用2020年质量支付计划数据进行横截面研究.
- 包括具有有效MIPS综合分数的医生实践.
- 基于计费实践定义的医院整合 (≥75%的服务通过医院门诊代码或税务标识符).
主要成果:
- 在医院综合和独立实践之间,在MIPS质量类别总体得分中没有发现显著差异.
- 这对于未调整和调整的分析 (控制实践规模,地理位置,专业和案例组合) 都是如此.
- 医院综合实践在一些 (但不是所有) 具体质量指标上获得了更高的分数.
结论:
- 医院整合似乎并没有为MIPS的质量表现提供实质性的优势.
- 该研究表明,单独的整合可能不足以在这种特定的基于价值的支付模式中带来更优质的结果.
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