Dr. Maganty on urologist engagement with MIPS
“Many were concerned that what the MIPS policy is really measuring is an ability to track and report measures as opposed to the actual provision of quality care,” says Avinash Maganty, MD.
In this video, Avinash Maganty, MD, discusses the background behind the Urology Practice study, “Merit-Based Incentive Payment System Quality Reporting in Urology Practices.” Maganty is a Society of Urologic Oncology fellow at the University of Michigan, Ann Arbor.
Transcription:
The Merit-based Incentive Payment System was initiated as part of the Medicare Access and CHIP Reauthorization Act of 2015, or MACRA. This was essentially one of the policies that provided one of the most extensive changes to the way in which physicians caring for Medicare patients are reimbursed, at least in recent history, and essentially adjusts the payment for each physician on a per claim basis, either up or down, depending on how the physician does across 4 categories, which MIPS measures as being quality, promoting interoperability, improvement activities, and spending. But a lot of people have raised concern that this policy may not be able to really track quality accurately and impact patient care in a meaningful way. Many were concerned that what the MIPS policy is really measuring is an ability to track and report measures as opposed to the actual provision of quality care. So we're interested in understanding how urologists in particular were engaging with this program, and specifically how their organizational context in which they practice could impact performance within the program. To do this, we basically created a measure for how urologists organize themselves based on how they were submitting their claims. We were essentially able to categorize urologists into these sort of broad categories of practice context, which include single-specialty or multi-specialty groups. And we're able to further categorize the single-specialty urology groups by their size or the number of urologists. That's the primary exposure of interest we were interested in looking at in terms of how does the context in which a urologist practice impact their performance within this program?
This transcription was edited for clarity.
Potential code for prior authorizations on AMA CPT Editorial Panel meeting agenda
March 28th 2024"Good public and economic policy must align costs, benefits, and incentives; currently, all costs are incurred by physician practices, and all financial savings and benefits from prior authorization accrue to health insurance plans, leading to perverse incentives,” says Alex Shteynshlyuger, MD.
