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Analysis: Physician Group Performance in Year 2 of the Medicare MIPS Program

VSSL has been a nationwide leader in evaluation and analysis of Medicare's Merit-based Incentive Payment System (MIPS) program.


The Lab built added to this body of work in a recent article published in JAMA Network Open. Led by VSSL team members Joshua Liao and Lingmei Zhou, the analysis sought to evaluate physician group performance in the second year of MIPS.


The analysis included 17,201 group practices representing 700,706 clinicians. Key results:


  • Most practices (66.2%) were exceptional performers, while one third (33.3%) were positive performers and very few were neutral (0.1%) or negative (0.5%) performers


  • Several characteristics varied by MIPS performance


Dr. Liao and team concluded:

The findings of this cross-sectional study suggest that despite more stringent composite score thresholds for 2020 payment adjustments, most practices achieved exceptional performance. Similar to the preceding year, performance varied by practice factors. Study limitations included unavailable payment adjustment information, the inability to infer causality about practice factors associated with MIPS performance, exclusion of the small proportion of clinicians (21%) participating in MIPS outside of group practices, and use of community-level variables. Nonetheless, performance thresholds could be revised to avoid designating most practices as exceptional, thereby diluting its meaning and policy impact. Policy makers could also consider practice factors to make MIPS scoring more equitable.

Read the paper here. Learn more about work in the VSSL portfolio here.