Health Care Professionals With High Socially At-Risk Caseloads Received Reduced MIPS Performance Scores

In 2019, health care professionals with high social-risk caseloads scored 13.4 points lower on the Merit-based Incentive Payment System (MIPS) performance, compared to MIPS clinicians with the lowest social at-risk caseloads. If qualifying clinicians received the Complex Patient Bonus in 2019, it would have increased MIPS performance scores by about 4.7%, and the likelihood of receiving exceptional performance bonus payments by about 2.8%.

The researchers concluded that health care professionals with the highest proportion of consumers dually eligible for Medicare and Medicaid had significantly lower MIPS scores compared with physicians with the lowest proportion . . .