Radiologists at a clear disadvantage in Medicare’s MIPS program, new study shows
New research lends further weight to what many already know: The Merit-Based Incentive Payment System places radiologists at a disadvantage compared to other medical specialties.
Medicare launched the payment program in 2017 to reward physicians for delivering quality care and lowering costs. However, radiologists have faced challenges since then, with too few measures applying to the specialty while others are no longer usable, experts wrote Wednesday in AJR [1].
New research from the Harvey L. Neiman Health Policy Institute further underlines the problem. In 2021, there were only nine available MIPS measures for diagnostic radiology versus 65 in family medicine. Physicians in radiology-only practices scored “significantly lower” in MIPS when compared to others working in doc groups where rads were not the predominant specialty.
“Our results clearly show that radiologists are at a disadvantage in the MIPS program, with very few available measures, most of which are topped out—meaning that scoring well isn’t possible because average scores are too high,” study co-author Lauren Nicola, MD, CEO of Triad Radiology Associates, said in a April 3 announcement. “Our study sends a clear message: The MIPS program in its current design won’t move the needle on quality in radiology. For MIPS to work as intended, physicians must report measures relevant to their specialty, which will require more measures that distinguish quality among radiologists.”
Nicola and colleagues gathered their information from the 2021 Centers for Medicare & Medicaid Services Provider Data Catalogue, pinpointing radiologists and practices participating in MIPS. The search turned up a total of 2,333 practices paired with 35,578 radiologists. They discovered that MIPS scores were “heavily influenced” by one factor.
“We looked at the top 10 measures reported most frequently by radiologists in each practice type. The results were striking—for radiologists in a multispecialty practice that wasn’t mostly radiologists, not a single radiology-focused measure was among that list,” lead author YoonKyung Chung, PhD, principal research scientist at the policy institute, said in the announcement.
Radiologists in multispecialty groups most frequently reported measures such as control of blood pressure and HbA1C (denoting diabetes control), screening for fall risk and hospital-wide unplanned readmission rates. None of these relate to the regular practice of diagnostic radiology, the authors noted. For radiologists working in diverse multispecialty groups, less than 2% of reported measures were related to radiology. Meanwhile, those working in radiology-focused practices scored “significantly lower” in MIPS compared to peers working in groups where radiology was not the predominant specialty.
“Under traditional MIPS, radiologists’ quality scores may not reflect the quality of radiology services, and the extent of this reporting discrepancy varies by practice specialty mix,” the study concluded. “These results support the needs to expand radiology measures and better align measure reporting with clinician specialty.”
Read much more at the link below, including potential study limitations.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.