Impact of Gaps in Merit-Based Incentive Payment System Measures on Marginalized Populations.

As the United States enters a new era of value-based payment heavy in emphasis on primary care measurement, careful examination of selected measures and their potential impact on outcomes and vulnerable populations is essential. Applying a theoretical model of health care quality as a coding matrix, we used a directed content analysis approach to categorize individual Merit Based Incentive Payment System (MIPS) measures. We found that most MIPS measures related to aspects of clinical effectiveness, whereas few, if any, related to aspects of access, patient experience, or interpersonal care. These gaps suggest that MIPS may fail to measure the broader aspects of health care quality and even risk worsening existing disparities.