Research ArticleOriginal Research
Primary Care Physicians' Conceptualization of Quality in Medicare's Merit-Based Incentive Payment System
Carl T. Berdahl, Molly C. Easterlin, Gery Ryan, Jack Needleman and Teryl K. Nuckols
The Journal of the American Board of Family
Medicine May 2021, 34 (3) 590-601; DOI: https://doi.org/10.3122/jabfm.2021.03.200555
Carl T. Berdahl
From the Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA (CTB, TKN); Department of Emergency Medicine, Cedars-Sinai Medical Center, West Hollywood, CA (CTB); University of California, Los Angeles (UCLA) National Clinician Scholars Program (CTB, MCE); Department of Pediatrics, Cedars-Sinai Medical Center (MCE); Division of Neonatal Medicine, Department of Pediatrics, Los Angeles County and University of Southern California Medical Center (MCE); Kaiser Permanente School of Medicine, Pasadena, CA (GR); Department of Health Policy and Management, UCLA Fielding School of Public Health (JN).
MD, MSMolly C. Easterlin
From the Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA (CTB, TKN); Department of Emergency Medicine, Cedars-Sinai Medical Center, West Hollywood, CA (CTB); University of California, Los Angeles (UCLA) National Clinician Scholars Program (CTB, MCE); Department of Pediatrics, Cedars-Sinai Medical Center (MCE); Division of Neonatal Medicine, Department of Pediatrics, Los Angeles County and University of Southern California Medical Center (MCE); Kaiser Permanente School of Medicine, Pasadena, CA (GR); Department of Health Policy and Management, UCLA Fielding School of Public Health (JN).
MD, MSGery Ryan
From the Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA (CTB, TKN); Department of Emergency Medicine, Cedars-Sinai Medical Center, West Hollywood, CA (CTB); University of California, Los Angeles (UCLA) National Clinician Scholars Program (CTB, MCE); Department of Pediatrics, Cedars-Sinai Medical Center (MCE); Division of Neonatal Medicine, Department of Pediatrics, Los Angeles County and University of Southern California Medical Center (MCE); Kaiser Permanente School of Medicine, Pasadena, CA (GR); Department of Health Policy and Management, UCLA Fielding School of Public Health (JN).
PhDJack Needleman
From the Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA (CTB, TKN); Department of Emergency Medicine, Cedars-Sinai Medical Center, West Hollywood, CA (CTB); University of California, Los Angeles (UCLA) National Clinician Scholars Program (CTB, MCE); Department of Pediatrics, Cedars-Sinai Medical Center (MCE); Division of Neonatal Medicine, Department of Pediatrics, Los Angeles County and University of Southern California Medical Center (MCE); Kaiser Permanente School of Medicine, Pasadena, CA (GR); Department of Health Policy and Management, UCLA Fielding School of Public Health (JN).
PhDTeryl K. Nuckols
From the Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA (CTB, TKN); Department of Emergency Medicine, Cedars-Sinai Medical Center, West Hollywood, CA (CTB); University of California, Los Angeles (UCLA) National Clinician Scholars Program (CTB, MCE); Department of Pediatrics, Cedars-Sinai Medical Center (MCE); Division of Neonatal Medicine, Department of Pediatrics, Los Angeles County and University of Southern California Medical Center (MCE); Kaiser Permanente School of Medicine, Pasadena, CA (GR); Department of Health Policy and Management, UCLA Fielding School of Public Health (JN).
MD, MSHSReferences
- 1.↵
- 2.↵Centers for Medicare and Medicaid Services, US Department of Health and Human Services. Medicare Access and CHIP Reauthorization Act of 2015. Pub. L. No 2015;114:2015.
- 3.↵Centers for Medicare and Medicaid Services, US Department of Health and Human Services. Merit-Based Incentive Payment System (MIPS) Overview. 2020. Available from: https://qpp.cms.gov/mips/overview. Accessed April 9, 2020.
- 4.↵Centers for Medicare and Medicaid Services, US Department of Health and Human Services. Medicare Program; Merit-Based Incentive Payment System (MIPS) and Alternative Payment Model (APM) Incentive Under the Physician Fee Schedule, and Criteria for Physician-Focused Payment Models. Final rule with comment period. Fed Regist 2016;81:77008–831. Available from: https://www.federalregister.gov/documents/2016/11/04/2016-25240/medicare-program-merit-based-incentive-payment-system-mips-and-alternative-payment-model-apm. Accessed May 4, 2021.
- 5.↵
- Verma S
- 6.↵Centers for Medicare and Medicaid Services, US Department of Health and Human Services. 2017 Quality Payment Program Reporting Experience. 2018.
- 7.↵
- Henry J
- 8.↵
- 9.↵
- Marmor RA,
- Clay B,
- Millen M,
- Savides TJ,
- Longhurst CA
- 10.↵
- Panagioti M,
- Geraghty K,
- Johnson J,
- et al
- 11.↵
- 12.↵
- Meyer GS,
- Nelson EC,
- Pryor DB,
- et al
- 13.↵
- Casalino LP,
- Gans D,
- Weber R,
- et al
- 14.↵
- Meltzer DO,
- Chung JW
- 15.↵
- Panzer RJ,
- Gitomer RS,
- Greene WH,
- Webster PR,
- Landry KR,
- Riccobono CA
- 16.↵Centers for Medicare and Medicaid Services, US Department of Health and Human Services. Reducing Burden. 2019 Available from: https://www.cms.gov/About-CMS/Components/CPI/Reducing-Burden. Accessed May 4, 2021.
- 17.↵
- 18.↵Medicare Payment Policy: Report to Congress. Washington, DC: Medicare Payment Advisory Commission; 2018. Available from: http://www.medpac.gov/docs/default-source/reports/mar18_medpac_entirereport_sec.pdf?sfvrsn=0. Accessed May 4, 2021.
- 19.↵
- Firth S
- 20.↵
- Soylu TG,
- Goldberg DG,
- Cuellar AE,
- Kuzel AJ
- 21.↵
- Berdahl CT,
- Easterlin MC,
- Ryan G,
- Needleman J,
- Nuckols TK
- 22.↵
- Liao JM,
- Shea JA,
- Weissman A,
- Navathe AS
- 23.↵
- 24.↵
- Barriball KL,
- While A
- 25.↵
- Patton MQ
- 26.↵Centers for Medicare and Medicaid Services, US Department of Health and Human Services. QPP Participation Status. 2020. Available from: https://qpp.cms.gov/participation-lookup. Accessed April 9, 2020.
- 27.↵Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC. 2001.
- 28.↵The development and implementation of quality improvement systems (QIS) in health care. Strasbourg: Council of Europe; 1997. Recommendation No. R(97)17 adopted by the Committee of Ministers of the Council of Europe on 30 September 1997 and explanatory memorandum.
- 29.↵
- 30.↵World Health Organization. Handbook for national quality policy and strategy: a practical approach for developing policy and strategy to improve quality of care. Geneva, Switzerland: World Health Organization; 2018.
- 31.↵European Commission. Key findings and recommendations on reporting and learning systems for patient safety incidents across Europe. Report of the reporting and learning subgroup of the European Commission. 2014.
- 32.↵
- Busse R,
- Klazinga N,
- Panteli D,
- Quentin W
- 33.↵Centers for Medicare and Medicaid Services, US Department of Health and Human Services. Consumer Assessment of Healthcare Providers and Systems (CAHPS) for the Merit-based Incentive Payment System (MIPS) Survey via CMS-Approved Survey Vendor Reporting. 2019. Available from: https://qpp.cms.gov/resource/CAHPS%20for%20MIPS%20Fact%20Sheet. Accessed May 4, 2021.
- 34.↵Centers for Medicare and Medicaid Services, US Department of Health and Human Services. CAHPS for MIPS Survey. 2020. Available from: https://www.cms.gov/Research-Statistics-Data-and-Systems/Research/CAHPS/mips.html. Accessed April 9, 2020.
- 35.↵
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Primary Care Physicians' Conceptualization of Quality in Medicare's Merit-Based Incentive Payment System
Carl T. Berdahl, Molly C. Easterlin, Gery Ryan, Jack Needleman, Teryl K. Nuckols
The Journal of the American Board of Family
Medicine May 2021, 34 (3) 590-601; DOI: 10.3122/jabfm.2021.03.200555
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