Large medical practices with a higher-grade of meaningful use of health IT were more engaged in reporting quality data and ultimately performed at a higher level on quality and cost measures in the first year of Medicare's Value-Based Payment Modifier program, according to a new study.
A team of researchers — led by Karen Joynt Maddox, MD, assistant professor of medicine at St. Louis-based Washington University School of Medicine — examined Physician Value-Based Payment Modifier program data from CMS for payment year 2015 based on performance in 2013 for their report, which was published in the December issue of Health Affairs.
In the first year, physicians in groups of 100 or more were required to report data on at least nine quality measures or a set of administrative claims-based measures designed by CMS to reflect care delivered beginning in 2013 or face a penalty. The authors found 1,010 practices that met this criterion, and 899 of which had at least one attributed beneficiary.
Here are six things to know.
1. Groups that successfully reported were more likely to have more than 200 clinicians while 74 percent of those that did not meet the minimum reporting had 100 to 199 practitioners.
2. Primary care-focused practices demonstrated better quality than other practices but maintained similar costs.
3. Nearly 263 practices (29.3 percent) of the 899 practices with at least one beneficiary failed to report performance data and received a 1 percent reporting-based penalty.
4. Of the nearly 636 practices (71 percent) that reported performance data, those that opted for quality tiering, meaning they voluntarily received performance-based penalties or bonuses, and those with a high use of EHRs, had better performance on quality and costs than others.
5. Ninety-one percent of the practices in both groups were in an urban setting.
6. Practices that had been penalized had younger patient populations, more black and Hispanic patients, and a greater number of patients dually eligible for Medicare and Medicaid.