Performance and Quality Measure Selection by Mohs Surgeons in the 2020 Merit-Based Incentive Payment System

Abstract

Background: The Merit-Based Incentive Payment System (MIPS) seeks to promote value-based care through quality-adjusted Medicare payments.

Objective: To assess 2020 MIPS performance and quality measure selection by Mohs surgeons.

Methods: Retrospective, cross-sectional review of Medicare Quality Payment Program and Part B billing data sets.

Results: In 2020, 8,778 dermatologists and 2,148 Mohs surgeons received a MIPS score. Mohs surgeons primarily participated through groups (51.6%) or individuals (36.4%). Most of them (77.4%) received a final score enabling a positive payment adjustment in 2022, with a notable proportion (22.3%) being eligible for a neutral payment adjustment in the setting of COVID-19 exemptions. The members of the American College of Mohs Surgery were more likely to meet the exceptional performance threshold (71.5% vs 59.0%, p < .0001), as were Mohs surgeons with <15 years of experience (73.3% vs 54.8%, p < .0001). Measures related to dermatology or Mohs surgery were reported by most individuals (92.0%) and dermatology groups (90.4%), yet less frequently by multispecialty groups (5.9%).

Conclusion: Many Mohs surgeons exceeded the performance threshold and used dermatology- or Mohs-related quality measures in 2020. Further assessments correlating quality measures with patient outcomes are needed to better understand the utility and appropriateness of the current value-based payment system and guide further policies.