National Healthcare Quality and Disparities Report
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 3 of 3 Research Studies DisplayedMaganty A, Hollenbeck BK, Kaufman SR
Implications of the merit-based incentive payment system for urology practices.
The purpose of this cross-sectional study was to analyze urologist performance in the Medicare merit-based incentive payment system (MIPS) for urology practices for 2017 and 2019 using Medicare data. MIPS scores were estimated by practice organization. The study found that urologists from small practices performed worse in MIPS and had a significantly lower adjusted odds ratio of receiving bonus payments in both 2017 and 2019 compared to larger group practices. Urologists who received penalties in 2017 had greater rates of consolidation by 2019 compared to those who were not penalized. The researchers concluded that smaller urology practices and urology practices caring for a greater percentage of dual eligible beneficiaries typically performed worse in the Medicare merit-based incentive payment system.
AHRQ-funded; HS025707.
Citation: Maganty A, Hollenbeck BK, Kaufman SR .
Implications of the merit-based incentive payment system for urology practices.
Urology 2022 Nov;169:84-91. doi: 10.1016/j.urology.2022.05.052..
Keywords: Payment, Provider Performance, Provider: Physician
Kanters AE, Evilsizer SK, Regenbogen SE
Correlation of colorectal surgical skill with patient outcomes: a cautionary tale.
Some have proposed that video-based skill assessments be used as a way to measure technical skills, quality improvement, and credentialing in colorectal surgeons and other practitioners. However, it must first be determined whether video-based assessments can accurately predict patient outcomes. The researchers assembled a panel of 10 peer surgeons to evaluate videos of minimally invasive colectomy procedures submitted by 21 surgeons. Each surgeon submitted one video, and the videos were edited to highlight key steps in the procedure. The panel and the surgeon participants were all associated with the Michigan Surgical Quality Collaborative. The panel used a validated American Society of Colon and Rectal Surgeons assessment instrument to rate the surgeon’s skills. The surgeon’s ratings were then linked to a validated registry of surgical outcomes, and the researchers assessed the relationship between skill level and risk-adjusted complication rates. The researchers found that after risk-adjustment there was no statistically significant difference in complication rates between the bottom (17.5%) and top (16.8%) quartile surgeons (p=0.41). The study concluded that there was no correlation between video-based peer rating of minimally invasive colectomy and postoperative complications among specialty surgeons, and that caution should be used when utilizing video review in credentialing.
AHRQ-funded; HS025365.
Citation: Kanters AE, Evilsizer SK, Regenbogen SE .
Correlation of colorectal surgical skill with patient outcomes: a cautionary tale.
Dis Colon Rectum 2022 Mar;65(3):444-51. doi: 10.1097/dcr.0000000000002124..
Keywords: Surgery, Provider: Physician, Provider Performance, Digestive Disease and Health, Outcomes
Reid RO, Tom AK, Ross RM
Physician compensation arrangements and financial performance incentives in US health systems.
This study examined physician compensation arrangements for primary care physicians (PCPs) and specialists among US health system-affiliated physician organizations (POs) and measured the portion of total physician compensation based on quality and cost performance. This study used a cross-sectional mixed-methods analysis of in-depth multimodal data (compensation document review, interviews with 40 PO leaders, and surveys conducted between November 2017 and July 2019) from 31 POs affiliated with 22 purposefully selected health systems in 4 states. The most common compensation arrangement was volume-based (68.2% mean for PCPs and 73.7% mean for specialists). Incentives for quality and cost performance were common, but compensation based on those were not common (9.0% mean for PCPs, 4.5% mean for specialists).
AHRQ-funded; HS024067.
Citation: Reid RO, Tom AK, Ross RM .
Physician compensation arrangements and financial performance incentives in US health systems.
JAMA Health Forum 2022 Jan;3(1):e214634. doi: 10.1001/jamahealthforum.2021.4634..
Keywords: Health Systems, Provider: Physician, Payment, Provider Performance