Alternative payment model reporting enhances MIPS performance

Radiologists perform better in the Merit-Based Incentive Payment System (MIPS) when they use group reporting rather than individual reporting, but utilizing MIPS-Alternative Payment Models (APMs) improves their performance within the system even more, according to a study published online in the Journal of the American College of Radiology on Oct. 25.

Lead study author Andrew B. Rosenkrantz, MD, of the department of radiology at NYU Langone Health in New York City, and colleagues aimed to assess radiologists’ performance in MIPS, paying special attention to the impact of the APMs created under the Medicare Access and CHIP Reauthorization Act. To do this, the researchers extracted data pertaining to radiologists’ 2017 MIPS performance from Physician Compare. Additional physician characteristics were extracted from multiple Centers for Medicare & Medicaid Services data sets.

Of the nearly 21,000 radiologists whose data were reviewed by the authors, 16% participated in MIPS using individual reporting; 68.9% using group reporting; and 13.4% using APM reporting. Physicians in the APM category were found to have the highest average quality scores, at 92.5%. Physicians in the individual reporting group had the lowest average quality scores (59.7%), while those in the group reporting category were found to have average quality scores of 84%.

Fractions of radiologists scored in advancing care Information were shown to be 4.1% for individual reporting users, 27% for group reporting users, and 100% for APM users. Average scores in this category were 61.9%, 94.6%, and 80.9%, respectively.

Meanwhile, of interventional radiologists in the advancing care information category, 27.7% were individual-reporting users and 42.7% were group-reporting users. However, few general radiologists or subspecialists other than interventional radiologists (less than five%) achieved scores that placed them in this category.

Average scores in improvement activities were also highest for subjects in the APM reporting group (100%). Subjects in the individual-reporting group displayed the lowest average score here (37.5%); subjects in the group-reporting category had an average score of 92.5%.

Additionally, an analysis of the data demonstrated a very significant disparity among the three groups when it came to average final scores—56.5% for practices using individual reporting, 85.6% for practices using group reporting, and 90.6% for practices using APM reporting. The overall benefits of APM reporting over group reporting were noted to be “most apparent” among smaller practices of 15 radiologists or fewer, at 84.1 for APM reporting compared with 75 for group reporting.

“Radiologists performed very well in the improvement activities category using group and APM reporting (in the latter case, automatically receiving full credit in this category), but poorly using individual reporting,” the researchers wrote. “This category’s activities merit attention and action by both individuals and groups, particularly given that scoring in this category will become more stringent for groups in future years. Based on our findings, we encourage radiologists participating in MIPS to carefully consider participation through an APM.”