Most Group Practices Achieve Exceptional Performance for MIPs Year 2

More than 99% of group practices scored as exceptional or positive performers the second year of Medicare’s Merit-Based Incentive Payment (MIPs) program, according to study results published in JAMA Network Open.

“The findings of this cross-sectional study suggest that despite more stringent composite score thresholds for 2020 payment adjustments, most practices achieved exceptional performance,” reported corresponding author Joshua M Liao, MD, MSc, the University of Washington School of Medicine, and coauthors in a research letter. “Similar to the preceding year, performance varied by practice factors.

Firmer composite scoring thresholds for 2020 followed 2019 thresholds so lenient that groups avoided penalties simply by reporting data, researchers explained. The study investigated how 17,201 group practices fared under 2020 adjustments.

According to the findings, composite scores the second year deemed 66.2% of group practices exceptional performers, 33.3% positive performers, 0.1% neutral performers, and 0.5% negative performers.

When researchers looked at practice characteristics, they found exceptional performers had larger patient populations compared with negative performers. However, compared with positive performers, exceptional performers were more often small practices (70.2% vs 65.8%).

Furthermore, the study found that exceptional performers had lower proportions of patients with dual eligibility for Medicare and Medicaid (median 19.1% vs 23%) and Black patients (median 4.5% vs 5.2%) compared with positive performers.

Albeit small, differences in urban status, regional health care spending, and educational attainment in local communities also existed between positive and exceptional performers, researchers reported.

“[P]erformance thresholds could be revised to avoid designating most practices as exceptional, thereby diluting its meaning and policy impact,” they concluded. “Policy makers could also consider practice factors to make MIPS scoring more equitable.”

Reference:
Liao JM, Zhou L, Navathe AS. Group practice performance in the second year of Medicare's Merit-Based Incentive Payment System. JAMA Netw Open. 2021 Oct 1;4(10):e2128267. doi:10.1001/jamanetworkopen.2021.28267