在质量支付计划下,ACO临床医生比MIPS临床医生拥有更高的医疗保险B部分医疗服务支付
Mina Shrestha1, Hari Sharma1, Keith J Mueller1
1The University of Iowa College of Public Health, Iowa City, IA, USA.
概括
在先进的替代支付模式 (A-APMs) 中,初级保健临床医生的医疗保险支付比在质量支付计划 (QPP) 下的基于优点的激励支付系统 (MIPS) 中的医疗保险支付更高. 这表明A-APMs可能会为参与的医生带来更大的财务收益.
科学领域:
- 卫生经济学 卫生经济学
- 医疗保健政策 医疗保健政策
- 医疗支付系统 医疗支付系统
背景情况:
- 质量支付计划 (QPP) 通过基于价值的支付模式激励医疗保险提供者.
- 有两个主要的轨道:先进的替代支付模式 (A-APMs) 和基于优点的激励支付系统 (MIPS).
- A-APMs和MIPS之间的差异性支付调整需要对其对临床医生支付的影响进行调查.
研究的目的:
- 为了比较Medicare Part B医疗服务支付在A-APMs和MIPS的初级保健临床医生之间.
- 分析QPP参与对不同临床医生群体支付轨迹的影响.
主要方法:
- 使用的医疗保险提供者使用和支付公共使用文件从2014-2018年.
- 在一大群初级保健临床医生中使用差异回归分析.
- 分析了来自50,879名独特的临床医生的254,395个观察结果.
主要成果:
- 与MIPS临床医生相比,A-APM中的临床医生获得的医疗保健B部分医疗服务支付显著更高 (1003.88美元).
- A-APM参与者经历了QPP进入后医疗服务支付的更大增长.
- 调查结果表明,更高的支付调整和可能转移到门诊服务有助于A-APM支付的增加.
结论:
- 参与A-APM与医疗保险B部分医疗服务支付的增加比MIPS更大.
- 决策者在评估QPP的有效性时,应考虑支付调整率和服务利用转移.
- 需要进一步评估,以了解A-APM和MIPS临床医生之间支付差异的驱动因素.
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