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. 2022 Mar 12;3(2):e12672.
doi: 10.1002/emp2.12672. eCollection 2022 Apr.

The future of value-based emergency care: Development of an emergency medicine MIPS value pathway framework

Cameron J Gettel  1   2 , Bradford Tinloy  3 , Susan M Nedza  4 , Michael A Granovsky  5 , Pawan Goyal  6 , Aisha T Terry  7 , Arjun K Venkatesh  1   8
Affiliations

The future of value-based emergency care: Development of an emergency medicine MIPS value pathway framework

Cameron J Gettel et al. J Am Coll Emerg Physicians Open. .

Abstract

The Centers for Medicare & Medicaid Services (CMS) implemented the Merit-based Incentive Payment System (MIPS) to accelerate the transition of physician payment toward value-based care models and away from traditional fee-for-service payment programs. In recent years, CMS has sought to modify the program by developing a MIPS Value Pathway (MVP) framework intended to use existing and future physician quality and cost measures to reward value-based care delivery. This article describes the multi-step process of the MVP Task Force, convened by the American College of Emergency Physicians (ACEP) to develop an emergency medicine-specific MVP proposal informed by diverse stakeholder perceptions regarding: (1) which existing quality measures reflect high quality emergency care, and (2) the degree to which emergency clinicians can impact clinical outcomes and cost for the care domains captured by existing quality measures. The MVP Task Force synthesized stakeholder feedback and underwent a consensus-building approach to develop the "Adopting Best Practices and Promoting Patient Safety within Emergency Medicine" MVP, recently reviewed and approved by CMS for national implementation starting in 2023. Our process and findings have broad implications for clinicians, administrators, and policymakers navigating the continued transition to value-based care in conjunction with CMS's implementation of the MVP framework.

Keywords: MIPS Value Pathway; consensus building; emergency medicine; quality measurement; value‐based care.

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Conflict of interest statement

MAG, ATT, and AKV serve on the Clinical Emergency Data Registry (CEDR) Committee within the American College of Emergency Physicians (ACEP). MAG is also the President of LogixHealth. AKV receives support for contracted work from the Centers for Medicare and Medicaid Services to develop hospital and healthcare outcome and efficiency quality measures and rating systems.

Figures

FIGURE 1
FIGURE 1
Perceived emergency clinician impact on clinical outcome and cost of 14 clinical care domains. Clinical care domains are placed in 1 cell within the 3 × 3 impact matrix based on a plurality of physician stakeholder responses
FIGURE 2
FIGURE 2
Perceived emergency clinician impact on clinical outcome and cost of 14 clinical care domains. Green represents a perceived high impact; yellow represents a perceived moderate impact; red represents a perceived low impact
See this image and copyright information in PMC

References

    1. Centers for Medicare & Medicaid Services . Quality Payment Program. Accessed March 4, 2021 https://qpp.cms.gov/about/qpp‐overview
    1. Gettel CJ, Han CR, Granovsky MA, et al. Emergency clinician participation and performance in the Centers for Medicare & medicaid services merit‐based incentive payment system. Acad Emerg Med. 2022;29(1):64‐72. - PMC - PubMed
    1. Pines JM, Venkat A. How to fix the Merit‐based Incentive Payment System (MIPS) in emergency medicine. Acad Emerg Med. 2022;29(1):128‐130. - PubMed
    1. Centers for Medicare & Medicaid Services . MIPS Value Pathways (MVPs). Accessed February 28, 2021.https://qpp.cms.gov/mips/mips‐value‐pathways
    1. Gettel CJ, Ling SM, Wild RE, et al. Centers for Medicare & Medicaid Services MIPS Value Pathways: opportunities for emergency clinicians to turn policy into practice. Ann Emerg Med. 2021;78(5):599‐603. - PMC - PubMed