Majority of physicians worried MIPS could harm patient care, study finds

Most physicians caring for Medicare patients are unaware how Medicare evaluates and pays them, but the majority of those physicians who do know these standards are concerned this approach could negatively affect patient care, a study published in Health Affairs found.

Researchers from Seattle-based UW Medicine and the University of Pennsylvania in Philadelphia looked at Medicare's Merit-based Incentive Payment System, or MIPS, which was implemented in January 2017.

"We found a significant number of physicians believed that there could be unintended consequences under these pay-for-performance incentives," said lead author Joshua Liao, MD.

Through MIPS, Medicare pays physicians based on how they perform in the following areas: reporting and performing on clinical quality measures, controlling how patients use resources, initiating or participating in clinical practice improvements and using EMRs.

To assess how physicians felt about MIPS, the researchers surveyed 700 internal medicine physicians across the U.S.

Three survey findings:

1. The majority (69 percent) of physicians reported being concerned physicians might "focus on aspects of care being measured to the detriment of other unmeasured aspects of care."

2. Sixty percent of respondents said physicians might "avoid sicker or more medically complex patients to improve performance on quality or utilization measures."

3. More than half of physicians (56 percent) said they wondered if physicians would change how they document care to improve their scores.

"These findings indicate there is an immediate and urgent need to continue educating physicians about MIPS requirements," Dr. Liao said. "Medicare should ask doctors what they think because we clearly found many physicians question where MIPS will really improve quality of care."

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