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RISE Registry Reveals Widespread MIPS Score Disparity for Rheumatologists
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SAN DIEGO — Quality measurements reported by rheumatology practices through the RISE registry varied widely in performance during the first quarter of 2017, which could result in fiscal consequences through the new Merit-Based Incentive Payment System, according to findings presented at the American College of Rheumatology Annual Meeting.
“Prior the Medicare and CHIP Reauthorization Act, otherwise known as MACRA, clinicians in the United States were paid on a fee-for-service basis under a sustainable growth rate formula that was used to control Medicare spending,” Jinoos Yazdany, MD, MPH, associate professor at the University of California, San Francisco School of Medicine, said during a press conference.
“The Merit-Based Incentive Payment System — or MIPS — is a new payment mechanism under MACRA that provides annual updates to physician payments starting in 2019 based on performance in four categories: quality of care; cost of care; clinical practice improvement activities; and advancing care information,” she said. “The MIPS program will fundamentally change the way rheumatologists are paid by increasingly tying payment to performance.”
To assess clinician performance for practices participating in the Rheumatology Informatics System for Effectiveness (RISE) registry in the first quarter of 2017, Yazdany and colleagues examined quality measures related to rheumatoid arthritis, drug safety, preventive care and gout from 548,990 patients reported by 491 clinicians in 109 practices. The researchers were then able to calculate performance by determining the percentage of eligible patients who received recommended care.
According to study results, performance on quality measures varied significantly across rheumatology practices; however, for 2 out of 5 measures for which the Medicare program has set national benchmarks, the average performance of RISE practices surpassed targets in the first quarter of 2017.
“Most rheumatologists take care of patients over the age of 65 and therefore most will be required to participate in MIPS since Medicare is big part of their financial viability as practices,” Yazdany said. “Our analyses revealed that 3,865 rheumatologists are eligible to participate in MIPS in 2017, and those who bill Medicare less than $30,000 a year or have fewer than 100 Medicare beneficiaries are exempt this year. However, the rules are changing: Next year, it will be $90,000 and 200 Medicare beneficiaries.”
To foster awareness of quality measure performance and assist rheumatologists in monitoring their own MIPS score, the American College of Rheumatology has developed a prototype dashboard for the RISE registry that can display scores across the four MIPS quality measure domains. Enabling rheumatologists to actively track their progress, the RISE-MIPS dashboard may enable clinicians to enact necessary changes to their practices to raise their score.
“For the first time, rheumatologists can join a national registry that not only collects data but also provides tools to measure quality of care and outcomes,” Yazdany said. “This will enable practices to see where they are performing well, where there is room for improvement, and as community we have an opportunity to build a learning health care system and work to adapt those successful workflows to improve care for our patients, as well as thrive financially under this new MIPS program.”– by Bob Stott
Reference:
Yazdany J, et al. Abstract 830. Presented at: American College of Rheumatology Annual Meeting; Nov. 4-8, 2017; San Diego.
Disclosures: Yazdany reports no relevant financial disclosures. Please see the full study for a complete list of all other authors’ relevant financial disclosures.