Medicare: Provider performance and experiences under the merit-based incentive payment system : report to congressional committees

Medicare: Provider performance and experiences under the merit-based incentive payment system : report to congressional committees

Collection:
Health Policy and Services Research
Alternate Title(s):
Provider performance and experiences under the merit-based incentive payment system
Contributor(s):
United States. Government Accountability Office, issuing body.
United States. Congress, issuing body.
Publication:
Washington, DC : United States Government Accountability Office, October 2021
Language(s):
English
Format:
Text
Subject(s):
Government Regulation
Quality Assurance, Health Care -- organization & administration
Reimbursement, Incentive
Stakeholder Participation
United States
United States.
Genre(s):
Technical Report
Abstract:
Why GAO did this study. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) changed how Medicare pays for physician services, moving from a payment system that largely rewarded volume and complexity of health care services to the Quality Payment Program, which is a payment incentive program intended to reward high-quality, efficient care. Providers participate in the Quality Payment Program through one of two tracks: MIPS or advanced alternative payment models. MIPS was designed to incentivize high-quality care through performance-based payment adjustments. About 950,000 providers (about half of all Medicare Part B providers) were eligible to participate in MIPS in 2019. Congress included a provision in MACRA for GAO to examine the MIPS program. This report describes (1) the distribution of MIPS performance scores and related payment adjustments, and (2) stakeholders’ perspectives on the strengths and challenges of the MIPS program. GAO analyzed MIPS data for performance years 2017 through 2019—the most recent year available at the time of GAO’s analysis. GAO also interviewed officials from CMS and 11 selected professional organizations that represent MIPS-eligible providers of various specialties. GAO identified stakeholders through research and its analysis of the MIPS data. The Department of Health and Human Services provided technical comments on a draft of this report, which GAO incorporated as appropriate.
Copyright:
The National Library of Medicine believes this item to be in the public domain. (More information)
Extent:
1 online resource (1 PDF file (iii, 55 pages))
Illustrations:
Illustrations
NLM Unique ID:
9918383083306676 (See catalog record)
Permanent Link:
http://resource.nlm.nih.gov/9918383083306676