AJMC August 17, 2021
Quality measurement in federal health care programs has been around since at least 2007, when CMS introduced the Physician Quality Reporting System (PQRS) for providers caring for Medicare beneficiaries. The program continued to evolve, and it eventually became part of CMS’ Merit-Based Incentive System (MIPS), CMS’ first attempt to integrate several different incentive-based programs under one umbrella, including PQRS and meaningful use.1 The goal of MIPS is to optimize patient care by utilizing financial incentives to encourage providers to deliver high-quality, cost-efficient care.
Although the program’s intentions are good, stakeholders have shared criticism of potential structural flaws in MIPS; these flaws may serve to prevent widespread adoption and discourage commercial payers from fully embracing the program and similar risk arrangements...
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