To What Extent Are the Centers for Medicare &amp; Medicaid Services 2019 MIPS Quality Measures Inclusive of Home-Based Medical Care?
Authors: Bruce Leff, Orla Sheehan, Shivani Bhatnagar, Krista L. Harrison, Randolph C. Barrows, Christine S. Ritchie
Journal: Annals of Internal Medicine (2020)

Letters4 August 2020To What Extent Are the Centers for Medicare & Medicaid Services 2019 MIPS Quality Measures Inclusive of Home-Based Medical Care?Bruce Leff, MD, Orla Sheehan, MD, PhD, Shivani Bhatnagar, BS, Krista L. Harrison, PhD, Randolph C. Barrows, MS, MD, and Christine S. Ritchie, MD, MSPHBruce Leff, MDJohns Hopkins University School of Medicine, Center for Transformative Geriatric Research, Johns Hopkins University Bloomberg School of Public Health, and Johns Hopkins School of Nursing, Baltimore, Maryland (B.L.), Orla Sheehan, MD, PhDJohns Hopkins University School of Medicine, Center for Transformative Geriatric Research, and Johns Hopkins University, Baltimore, Maryland (O.S.), Shivani Bhatnagar, BSTexas College of Osteopathic Medicine and University of North Texas Health Science Center, Fort Worth, Texas (S.B.), Krista L. Harrison, PhDUniversity of California, San Francisco, San Francisco, California (K.L.H.), Randolph C. Barrows, MS, MDElimu Informatics, Richmond, California (R.C.B.), and Christine S. Ritchie, MD, MSPHMassachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (C.S.R.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M20-0235 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Two million older adults are completely or mostly homebound, and another 5.3 million have difficulty or need help getting out of their homes (1). Multiple studies, including the Centers for Medicare & Medicaid Services (CMS) Independence at Home Demonstration, have proven that home-based primary care is effective in providing cost-saving, high-quality care to high-need, high-cost, homebound older adults (2).Making home-based primary care available to frail older adults will require better financial incentives to encourage provision of this type of care. A potentially important opportunity for home-based primary care practices to enter into value-based care is to leverage performance ...References1. Ornstein KA, Leff B, Covinsky KE, et al. Epidemiology of the homebound population in the United States. JAMA Intern Med. 2015;175:1180-6. [PMID: 26010119] doi:10.1001/jamainternmed.2015.1849 CrossrefMedlineGoogle Scholar2. Stall N, Nowaczynski M, Sinha SK. Systematic review of outcomes from home-based primary care programs for homebound older adults. J Am Geriatr Soc. 2014;62:2243-51. [PMID: 25371236] doi:10.1111/jgs.13088 CrossrefMedlineGoogle Scholar3. U.S. Department of Health and Human Services. MIPS overview. Accessed at https://qpp.cms.gov/mips/overview on 25 October 2019. Google Scholar4. Yao NA, Ritchie C, Cornwell T, et al. Use of home-based medical care and disparities. J Am Geriatr Soc. 2018;66:1716-1720. [PMID: 30084141] doi:10.1111/jgs.15444 CrossrefMedlineGoogle Scholar5. Leff B, Carlson CM, Saliba D, et al. The invisible homebound: setting quality-of-care standards for home-based primary and palliative care. Health Aff (Millwood). 2015;34:21-9. [PMID: 25561640] doi:10.1377/hlthaff.2014.1008 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Johns Hopkins University School of Medicine, Center for Transformative Geriatric Research, Johns Hopkins University Bloomberg School of Public Health, and Johns Hopkins School of Nursing, Baltimore, Maryland (B.L.)Johns Hopkins University School of Medicine, Center for Transformative Geriatric Research, and Johns Hopkins University, Baltimore, Maryland (O.S.)Texas College of Osteopathic Medicine and University of North Texas Health Science Center, Fort Worth, Texas (S.B.)University of California, San Francisco, San Francisco, California (K.L.H.)Elimu Informatics, Richmond, California (R.C.B.)Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (C.S.R.)Financial Support: This work was supported by grants from West Health Institute and The John A. Hartford Foundation. Dr. Harrison was supported by a National Institute on Aging Mentored Research Scientist Development Award (K01AG059831).Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M20-0235.Reproducible Research Statement: Study protocol: Not available. Statistical code: Not applicable. Data set: Available from Dr. Leff (e-mail, [email protected]edu).Corresponding Author: Bruce Leff, MD, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Center for Transformative Geriatric Research, 5200 Eastern Avenue, Baltimore, MD 21224; e-mail, [email protected]edu.This article was published at Annals.org on 19 May 2020. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byThe National Home-Based Primary Care Learning Network: A Practice-Based Quality Improvement and Research NetworkHome-Based Medical Care for Homebound Elderly with Mobility Impairment in the U.S.Home-Based Care Reimagined: A Full-Fledged Health Care Delivery Ecosystem Without WallsUsing Registry Data to Support National Quality Forum Endorsement of Quality Measures for Home-Based Medical CareHome‐Based Medical Care: High‐Value Health Care During Coronavirus Disease 2019 and Beyond 4 August 2020Volume 173, Issue 3Page: 243-245KeywordsDisclosureElderlyGeriatricsHealth careMedical servicesMedicareMotivationPatientsPregnancyScientists ePublished: 19 May 2020 Issue Published: 4 August 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...