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Time and Financial Costs for Physician Practices to Participate in the Medicare Merit-based Incentive Payment System

The U.S. Centers for Medicare & Medicaid Services (CMS) Merit-based Incentive Payment System (MIPS), a major value-based purchasing program that influences payment for more than one million clinicians annually, came into effect in 2017. In a new study published in JAMA Health Forum, Dr. Dhruv Khullar, assistant professor of population health sciences; Dr. Amelia Bond, assistant professor of population health sciences; Eloise O’Donnell, senior research program manager in population health sciences; Yuting Qian, research coordinator in population health sciences; and Dr. Lawrence Casalino, professor of population health sciences; worked with Medical Group Management Association colleague David Gans to understand the cost for physician practices to participate in MIPS. To do this, the researchers interviewed 30 leaders of physician practices participating in the MIPS program, including those in MIPS alternative payment models. They calculated time required by staff and financial costs of participation per physician across practices of different size, specialty, and census region in 2019. The mean per-physician cost to practices participating in MIPS was $12,811, while physicians, clinical staff, and administrative staff together spent 201.7 hours per physician on annual MIPS-related activities. With significant time and financial costs of participation being reported, the researchers suggest that policymakers should consider ways to reduce these burdens. In an invited commentary on the study, Dr. Jason Hockenberry of Yale School of Public Health noted the importance of addressing these burdens quickly, as well as raising the question of how practices could be better reimbursed for participation.

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