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Study Finds MIPS Scores Don’t Reflect True Quality Performance

Study Finds MIPS Scores Don’t Reflect True Quality Performance

January 17, 2023Jacqueline LaPointeRevCycle IntelligenceQuality Metrics, Quality Reporting, Clinical Quality Measures (CQMs)

A recent study out of the Weill Cornell Medical College questions whether the Merit-Based Incentive Payment System (MIPS) accurately captures the quality of care delivered by primary care physicians.

Published in JAMA in December, the cross-sectional observational study of over 80,200 primary care physicians found that MIPS scores were inconsistently related to performance on both process and outcome measures. Physicians treating more medically complex and socially vulnerable patients were also more like to receive low MIPS scores even when they provided relatively high-quality care, according to the study.

MIPS is a mandatory reimbursement program for Medicare providers, including physicians, physician assistants, and nurse practitioners, as long as they bill enough for Part B-covered professional services and see enough Part B patients based on Medicare-set levels. Nearly 1 million providers participate in MIPS every year.

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