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Oct 22, 2022 •257 likes •328 views

How is MIPS working? At what cost? Is this the best we can do? Aaron Lyss alyss@tnonc.com Disclaimer: this presentation includes opinions and perspectives that should not be assumed to reflect official policies or positions of Tennessee

  1. How is MIPS working? At what cost? Is this the best we can do? Aaron Lyss alyss@tnonc.com Disclaimer: this presentation includes opinions and perspectives that should not be assumed to reflect official policies or positions of Tennessee Oncology PLLC.

  2. Adaptation to new payment models “Challenges, Perceptions, and Readiness of Oncology Clinicians for the MACRA Quality Payment Program” • 4% “in-depth knowledge • 9% never heard of it • 44% recognized the name but not familiar w/ requirements • 43% somewhat familiar JAMA Oncol. 2018;4(2):252-253. doi:10.1001/jamaoncol.2017.3773 https://jamanetwork.com/journals/jamaoncology/ article-abstract/2663954. “Medicare Accountable Care Organization Results For 2015: The Journey To Better Quality And Lower Costs Continues,” Health Affairs Blog, Sep. 2016. https://www.healthaffairs.org/do/10.1377/hblog20160909.056418/full/ Disclaimer: this presentation includes opinions and perspectives that should not be assumed to reflect official policies or positions of Tennessee Oncology PLLC.

  3. Impact so far? ? X health patient outcomes experience ? X workforce cost health Disclaimer: this presentation includes opinions and perspectives that should not be assumed to reflect official policies or positions of Tennessee Oncology PLLC.

  4. Is this the best we can do? Intentions: Intentions: • correlate w/ program requirements & 1. create performance-based variation in measures reimbursement • include patient experience measures & 2. reimbursement commensurate with required patient-centric activities provider influence over the outcome Reality: 3. increase provider consideration of cost • relative impact on program performance overwhelmed by extent of other requirements & measures PATIENT HEALTH EXPERIENCE OUTCOMES • Computer-centric > patient-centric WORKFORCE COST HEALTH Individual frustration: • Care teams prefer patients to computers, time is zero sum Reality: • Insufficiently nuanced for specialists Organizational economics: • Questionable counterfactual outcomes & cost • Performance driven by increase in technology and FTE resources Disclaimer: this presentation includes opinions and perspectives that should not be assumed to reflect official policies or positions of Tennessee Oncology PLLC.

  5. Could there be a better alternative? “If everything is important, then nothing is” -- Patrick Lencioni Disclaimer: this presentation includes opinions and perspectives that should not be assumed to reflect official policies or positions of Tennessee Oncology PLLC.

  6. Why not A-APM? Disclaimer: this presentation includes opinions and perspectives that should not be assumed to reflect official policies or positions of Tennessee Oncology PLLC.

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