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September 8, 2020

Potential Adverse Financial Implications of the Merit-based Incentive Payment System for Independent and Safety Net Practices

Author Affiliations
  • 1Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, New Hampshire
  • 2Cityblock Health, New York, New York
  • 3Ariadne Labs, Brigham and Women’s Hospital, Boston, Massachusetts
  • 4T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts
JAMA. 2020;324(10):948-950. doi:10.1001/jama.2020.13093

Health care payment design requires careful monitoring and evaluation to understand and avoid unintended adverse consequences. In 2019, US clinicians began to be rewarded or penalized up to 4% of revenue under the Centers for Medicare & Medicaid Services Merit-based Incentive Payment System (MIPS). Clinicians can choose measures for evaluation from 3 categories: quality, meaningful use, and improvement activities.

The reports in this issue of JAMA by Johnston et al1 and by Khullar et al2 evaluated the MIPS performance scores of clinicians and the potential financial implications associated with the MIPS program. The authors found meaningful advantages for clinicians associated with health care systems and among those who treated fewer patients with low socioeconomic status and complex medical needs.

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