NCQA is urging CMS to use an automated decision-tree model to determine which patients physicians are responsible for, since they are rated on quality and resource use under the new Merit-Based Incentive Payment Systems (MIPS). Decision-tree models can reduce the reporting burden for clinicians and enable them to select the most appropriate patient/clinician relationship within the course of routine workflows. Existing health IT systems allow decision-tree models to be embedded, and include routinely collected information such as clinician specialty, location of service, prior treatment history and CPT codes. NCQA believes this approach may not solve all attribution issues, but it would address the vast majority of them.
See the letter and comments in full below:
Michael Braaten is Senior Corporate Relations Lead with NCQA and has been with the organization since 2016.