New CMS Merit-Based Incentive Payment System Value Pathway After Total Knee and Hip Arthroplasty: Preparing for Mandatory Reporting

Document Type

Journal Article

Publication Date

1-24-2024

Journal

The Journal of arthroplasty

DOI

10.1016/j.arth.2024.01.037

Keywords

Medicare; patient reported outcome measure; payment; performance; total hip arthroplasty; total knee arthroplasty

Abstract

INTRODUCTION: This article discusses the implementation of a new Merit-Based Incentive Payment System Value Pathway (MIP MVPs) applicable to elective total hip (THA) and total knee arthroplasty (TKA) as created by Medicare and Medicaid Services (CMS) - the Improving Care for Lower Extremity Joint Repair MVP (MVP ID: G0058). We describe specific quality measures (QMs), surgeon-hospital collaborations, future developments with Quality Payment Program (QPP), and how lessons from early implementation will empower clinicians to participate in the refining of this MVP. CONCLUSIONS: The CMS has designed MVPs as a subset of measures relevant to a specialty or medical condition, in an effort to reduce the burden of reporting and improve assessment of care quality. Physicians and payors must be mindful of detrimental effects these measures in their current form may have on surgeons, institutions, and patients, including disincentivizing care for sicker or more vulnerable populations, and increased administrative costs. Early voluntary participation is crucial in order to gain valuable experience for the orthopaedic community and in an effort to work alongside CMS to maximize care while minimizing cost for patients and burden for providers.

Department

Orthopaedic Surgery

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