评估基于功绩的激励支付系统中质量测量报告的现状
1Clinical Research Associate, Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School, Ann Arbor, MI, USA; Medical Student, Wayne State University School of Medicine, Detroit, MI, USA.
American journal of surgery
|February 22, 2026
概括
非初级保健专业的医生仍然拥有较少的基于功绩的激励支付系统 (MIPS) 质量措施,影响他们的医疗保险B部分支付调整. 这项研究强调了2021-2024年MIPS质量测量可用性的持续差异.
科学领域:
- 卫生政策 卫生政策
- 医学经济学 医学经济学
- 提高质量 提高质量
背景情况:
- 基于功绩的激励支付系统 (MIPS) 将医生Medicare Part B支付与质量测量报告联系起来.
- 非初级保健专业的医生在MIPS早期 (2017-2020年) 面临着有限的质量测量选择.
- 这种差异可能使非初级保健医生在实现积极的支付调整方面处于不利地位.
研究的目的:
- 评估MIPS质量测量量数量和特征在2021年至2024年期间在医疗专业之间是否存在显著变化.
- 分析这些变化对医生薪酬调整的影响.
主要方法:
- 一项纵向质量改进研究分析了医疗保险和医疗补助服务中心 (CMS) 质量支付计划 (QPP) 的2021-2024年公共使用文件数据.
- 描述性统计数据被用来评估每种专业可用的MIPS和合格临床数据注册表 (QCDR) 措施的数量和特征.
- 结果包括测量计数,独特的测量,QCDR可用性,以及测量特征,如Donabedian类和topped-out状态.
主要成果:
- 与初级保健相比,非初级保健专业报告的独特质量测量和测量和收集类型组合显著减少 (p < 0.001).
- 过程测量是最常见的,除了神经外科,骨科和血管外科外.
- 在2024年,大约有40.9%的测量和收集类型组合被"顶出",限制了有效的绩效分层.
结论:
- 在MIPS质量测量可用性的显著变化持续到2024年,不成比例地影响非初级保健专业.
- 调查结果强调需要进行政策调整,以确保为积极的医疗保险B部分支付调整提供公平的机会.
- 未来的MIPS修改应该旨在使所有医生专业的测量可用性均等.
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