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UPJ INSIGHT Merit-based Incentive Payment System Quality Reporting in Urology Practices
By: Avinash Maganty, MD, MS, University of Michigan, Ann Arbor; Noah Krampe, BA, University of Michigan, Ann Arbor; Anup A. Shah, MD, Santa Clara Valley Medical Center, San Jose, California; Vishnukamal Golla, MD, MPH, Duke National Clinician Scholars Program, Duke University School of Medicine, Margolis Center for Health Policy, Duke University, Durham, North Carolina, Durham Veterans Affairs Health Care System, North Carolina | Posted on: 18 May 2023
Maganty A, Krampe N, Shah AA, Golla V. Merit-based incentive payment system quality reporting in urology practices. Urol Pract. 2023;10(3):244-252.
Study Need and Importance
The Merit-based Incentive Payment System (MIPS) represents one of the most extensive changes to the way in which physicians are reimbursed. MIPS attempts to move from volume towards value by adjusting reimbursement based on performance across quality measures and per beneficiary spending. Most urologists caring for Medicare beneficiaries will be subject to the policies within MIPS. However, with few measures specific to urological conditions within the program, it remains unclear what measures urologists are choosing to track and report.
What We Found
During the 2020 performance year, most urologists reported as part of a group or alternative payment model (56% and 30%, respectively), while few reported as an individual (14%). The most frequently reported measures were relevant to primary care and not specific for urological conditions. Moreover, only 11% of urologists reported at least 1 urology-specific measure (see Figure) and only 3% reported measures from qualified registries such as AQUA (American Urological Association Quality Registry).
Limitations
These findings must be considered in the context of several limitations. First, this data is publicly available through Centers for Medicare & Medicaid Services, and may contain missing or incomplete information. Second, we explored urology-specific measures, but other measures may provide meaningful improvements to patient care. Third, this is a retrospective analysis of a single performance year during the COVID-19 pandemic, during which time practice patterns were likely altered.
Interpretation for Patient Care
Our study highlights that most measures submitted under urologists do not align with the diseases they treat. This raises concern that participation in this program—which likely imposes significant time and financial burden for physicians—is unlikely to improve the quality of care for patients with urological conditions.
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