Evidence map›Paper›PMID 34693261›Full record

ArticleKidney medicine

Nephrologist Performance in the Merit-Based Incentive Payment System.

Sri Lekha Tummalapalli, Mallika L Mendu, Sarah A Struthers, David L White, Scott D Bieber, Daniel E Weiner, Said A Ibrahim

Open access · goldAbstract read
In one paragraph

Article in Kidney medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
3.0field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 13 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 6 institutions in 1 country.

Sri Lekha TummalapalliDivision of Healthcare Delivery Science & Innovation, Department of Population Health Sciences, Weill Cornell Medicine, New York, NY.
Mallika L MenduDivision of Renal Medicine, Brigham and Women's Hospital, Harvard Medical School.
Sarah A StruthersDivision of Nephrology, Department of Medicine, University of Washington, Seattle, WA.
David L WhiteAmerican Society of Nephrology, Washington, DC.
Scott D BieberKootenai Health, Coeur d'Alene, ID.
Daniel E WeinerDivision of Nephrology, Department of Medicine, Tufts Medical Center, Boston, MA.
Said A IbrahimDivision of Healthcare Delivery Science & Innovation, Department of Population Health Sciences, Weill Cornell Medicine, New York, NY.
Cornell University · USAmerican Society of Nephrology · USBrigham and Women's Hospital · USKootenai Medical Center · USTufts Medical Center · USUniversity of Washington · US

Funding

Screening Strategies for Chronic Kidney Disease in US PopulationsF32DK122627 · NIDDK · WEILL MEDICAL COLL OF CORNELL UNIV · PI TUMMALAPALLI, SRI LEKHA · 2019 to 2021
$159k
NIDDK NIH HHS F32 DK122627
6 · The paper itself

Abstract

RATIONALE &

objectiveThe Merit-Based Incentive Payment System (MIPS) is the largest quality payment program administered by the Centers for Medicare & Medicaid Services. Little is known about predictors of nephrologist performance in MIPS. STUDY

designCross-sectional analysis. SETTING &

participantsNephrologists participating in MIPS in performance year 2018. PREDICTORS: Nephrologist characteristics: (1) participation type (individual, group, or MIPS alternative payment model [APM]), (2) practice size, (3) practice setting (rural, Health Professional Shortage Area [HPSA], or hospital based), and (4) geography (Census Division). OUTCOMES: MIPS Final, Quality, Promoting Interoperability, Improvement Activities, and Cost scores. Using published consensus ratings, we also examined the validity of MIPS Quality measures selected by nephrologists. ANALYTICAL APPROACH: Unadjusted and multivariable-adjusted linear regression models assessing the associations between nephrologist characteristics and MIPS Final scores.

resultsAmong 6,117 nephrologists participating in MIPS in 2018, the median MIPS Final score was 100 (interquartile range, 94-100). In multivariable-adjusted analyses, MIPS APM participation was associated with a 12.5-point (95% CI, 10.6-14.4) higher score compared with individual participation. Nephrologists in large (355-4,294 members) and medium (15-354 members) practices scored higher than those in small practices (1-14 members). In analyses adjusted for practice size, practice setting, and geography, among individual and group participants, HPSA nephrologists scored 1.9 (95% CI, -3.6 to -0.1) points lower than non-HPSA nephrologists, and hospital-based nephrologists scored 6.0 (95% CI, -8.3 to -3.7) points lower than non-hospital-based nephrologists. The most frequently reported quality measures by individual and group participants had medium to high validity and were relevant to nephrology care, whereas MIPS APM measures had little relevance to nephrology. LIMITATIONS: Lack of adjustment for patient characteristics.

conclusionsMIPS APM participation, larger practice size, non-HPSA setting, and non-hospital-based setting were associated with higher MIPS scores among nephrologists. Our results inform strategies to improve MIPS program design and generate meaningful distinctions between practices that will drive improvements in care.

Indexed as

Chronic kidney diseaseHypertensionMerit-based Incentive Payment System (MIPS)NephrologyQuality improvementQuality measuresQuality metricsQuality payment program

Identifiers

PMID34693261
PMCPMC8515074
OpenAlexW3184049956

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.