复杂的患者得分有意义地影响2022年医疗保险基于优点的激励支付系统 骨科外科医生的奖金支付
Shirley H Fung1,2, Timothy E Stump3, Adam Ciarleglio4
1Department of Health, Human Function, and Rehabilitation Sciences, School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA.
The Permanente journal
|October 24, 2025
概括
最近的优点激励支付系统 (MIPS) 政策变化影响了整形外科医生. 较高的门降低了奖金,而复杂的患者奖金改善了支付,但股权差距仍然存在.
科学领域:
- 医疗保健政策 医疗保健政策
- 整形外科手术 整形外科手术
- 医疗保健服务研究 医疗服务研究
背景情况:
- 基于功绩的激励支付系统 (MIPS) 显著影响了超过60万名临床医生的医疗保险补偿,其中包括大约15,000名骨科外科医生.
- 不断发展的MIPS政策需要研究,以指导骨科外科医生优化性能和理解支付调整.
- 关于近期MIPS政策变化对骨科外科医生的表现和护理质量的影响的研究有限.
研究的目的:
- 评估最近MIPS政策变化对骨科外科医生的支付调整的影响.
- 检查MIPS在骨科手术中提高护理质量的作用.
- 根据实践规模和政策变化,评估骨科外科医生之间MIPS奖金支付的差异.
主要方法:
- 从近9000名骨科外科医生的2021-2022年MIPS绩效数据进行了回顾性分析.
- 统计方法包括McNemar的测试和混合效应物流回归来评估政策影响.
- 根据MIPS政策修改,研究了支付调整和奖金支付可能性的变化.
主要成果:
- 将MIPS绩效值提高到75点,显著降低了获得奖金支付的可能性 (P < .01).
- 较小实践的外科医生获得奖金的几率要低得多 (OR,0.40;P < .008),尽管这种差异已经缩小.
- 更新的复杂患者奖金评分政策显示,它对奖金支付概率产生了最强的积极影响 (OR,6.49;P < .017).
结论:
- 进一步提高MIPS绩效值可能会加剧临床医生的不满.
- 尽管有一些政策改进,但在小型和农村骨科实践中仍然存在显著的公平差距.
- 修订后的复杂患者奖金政策有效地激励和奖励管理高风险患者群体的临床医生.
关键词:
在 MIPS 价值路径中.美国医疗保险 (Medicare) 的医疗保险.基于功绩的激励支付系统医疗保健的质量 医疗保健的质量整形外科医生 整形外科医生质量措施 质量措施基于价值的激励支付是基于价值的激励支付.更多相关视频
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