Interventional Radiologist Performance in the Merit-Based Incentive Payment System in Performance Year 2020

The Merit Based Incentive Payment System (MIPS) is part of CMS’ Quality Payment Program, an initiative to shift providers to a pay-for-performance model. The recent performance of interventional radiologist physicians (IR) in this program has, to the best of our knowledge, not yet been characterized.  We aim to evaluate IR’s performance in MIPS in performance year (PY) 2020.

Materials and Methods:

A retrospective, cross-sectional analysis of IR participation in MIPS for PY 2020 was conducted using the Provider Data Catalog, a publicly available set of datasets published by the Center for Medicare and Medicaid Services (CMS). IR were identified by the primary medical specialty reported by the individual clinician. The proportion of IR participating in MIPS in PY2020 was determined. Payment adjustments were determined using CMS’ published methodology (bonus: >85; positive: >45 and < 85; neutral: 45; and penalty:< 45) and stratified by participation option (individual, group, and alternative payment model (APM)).

Results:

For PY2020, 1411 of 2229 (63.3%) unique IR participated in MIPS. Scores were provided for each physician at each practice location for a total of 2503 instances. IR participated as individual, group, or APM in 79 (3.2%), 1765 (70.5%), and 659 (26.3%) instances respectively. The distribution of IR for MIPS adjustments for bonus, positive, neutral, and penalty were 2071 (82.7%), 274 (10.9%), 133 (5.3%), and 25 (1.0%) instances respectively. Stratified by participation option, 618 (93%) of APM, 1428 (80.9%) of group, and 25 (31.6%) of individual IR received the bonus payment; 1 (0.1%) of APM, 265 (15%) of group, and 8 (10.1%) of individual IR received a positive payment; 40 (6%) of APM, 47 (2.6%) of group, and 46 (58%) of individual IR received neutral payment; and 0 (0%) of APM, 25 (1.4%) of group, and 0 (0%) of individual IR received a penalty.

Conclusion:

IR overall performed well in MIPS for PY 2020, with most IR physicians receiving bonus payments. Compared to APM and group affiliated IR, individual IR performed less well with majority not qualifying for bonus or positive payment adjustment. As the MIPS continues to evolve and thresholds likely to increase, measures should be taken to ensure that all IR and particularly individual IR are equipped to continually perform well or improve on MIPS.