基于骨科外科医生的优点激励支付系统 (MIPS) 绩效,人口统计和基于患者社会风险的患者人群的差异
Alejandro M Holle1, Eugenia Lin2, Vikram S Gill2
1Mayo Clinic Alix School of Medicine, Phoenix, Arizona.
The Journal of bone and joint surgery. American volume
|June 25, 2025
概括
基于优点的激励支付系统 (MIPS) 改变了治疗高社会风险患者的整形外科医生的得分. 然而,这些人群的外科医生人口统计和实践模式保持一致.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 整形外科手术 整形外科手术
- 卫生政策 卫生政策
背景情况:
- 医疗保险和医疗补助服务中心 (CMS) 基于优点的激励支付系统 (MIPS) 已发展为支持高社会风险患者的护理.
- 这些MIPS修改对外科医生的表现和患者选择的影响仍在调查中.
研究的目的:
- 评估骨科外科医生MIPS得分,人口统计,实践特征和患者群体的变化,基于2017年至2021年间患者的社会风险.
主要方法:
- 利用CMS数据分析了美国骨科外科医生,根据医疗保险和医疗补助的双重资格将他们分为社会风险五分之一.
- 评估了2017年和2021年的人口统计,实践位置,患者数据和MIPS表现.
- 雇员千方形,学生t测试,威尔科克森签名等级测试和多变量后勤回归来比较社会风险五分位数.
主要成果:
- 2017年,具有最高社会风险病例负载的外科医生MIPS得分较低 (66.0±37.6),而风险最低的外科医生 (70.1±33.5).
- 到2021年,具有最高社会风险病例负载的外科医生比具有最低风险 (81.5 ± 18.3) 的外科医生获得显著更高的MIPS得分 (88.7 ± 16.9).
- 在2021年,处于最高社会风险组的外科医生更有可能是女性,拥有DO学位,最近毕业,并在社区困境较高的地区执业.
结论:
- 2020年将复杂患者奖金添加到MIPS可能已经减轻了为服务于高社会风险人群的外科医生的绩效差异.
- 护理高社会风险人群的骨科外科医生的人口统计和实践模式从2017年到2021年保持一致.
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