Challenges of Measuring Costs of Care for US Practices.

Abstract

As the US healthcare system transitions from fee-for-service to value-based purchasing, evaluating physician practice performance on cost is central to driving value. Two measures—Total per Capita Cost (TPCC) and Medicare Spending per Beneficiary (MSPB)—comprise the cost domain in Medicare’s mandatory physician value-based purchasing program: the Merit-based Incentive Payment System (MIPS). Therefore, we sought to describe the feasibility of applying claims-based cost measures included in MIPS to practices nationwide, and to assess whether feasibility varies by practice size or specialty mix.