# Impact of the Merit-Based Incentive Payment System on the Quality of Prostate Cancer Care

> **NIH NIH F32** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2022 · $85,550

## Abstract

PROJECT SUMMARY
Prostate cancer is the second leading cause of cancer death among men in the United States. It
remains a challenging disease to treat given that many men do not benefit from immediate
treatment, either due to slow-progressing disease or competing risks. This uncertainty about whether
and when to treat has resulted in considerable variation in the management of prostate cancer,
which we have shown to be driven by non-clinical factors such as financial incentives. Fee-for-
service payment models provide incentives for utilization, but this may not always lead to benefits for
patients, and in some instances can be harmful. Therefore, designing payment models that advance
high-value healthcare by promoting both quality and reduced spending is critical.
The Merit-Based Incentive Payment System (MIPS) in fee-for-service Medicare, introduced as part
of the Medicare Access and CHIP Reauthorization Act, is a payment model that aims to improve the
value of care by tracking quality measures and monitoring spending. Understanding how motivations
to reduce spending implied by the MIPS policy affect quality and access to prostate cancer care is
crucial. As Medicare annually escalates the weight of the spending component, spending is
becoming increasingly important in determining success within the program. However, incentives to
reduce spending may not always align with quality care. Additionally, incentives to reduce spending
may have unintended consequences. For example, physicians may be influenced to avoid
vulnerable populations, who are associated with the highest cost of care and worse cancer
outcomes, in order to improve their performance within the program. In light of this, understanding
the impact of the policy on quality of care and access for vulnerable populations is crucial.
Using national Medicare claims data linked to physician quality reporting files, we will identify the
impact of MIPS on quality and access to prostate cancer care utilizing methods adopted from
econometrics. We will specifically assess the policy’s impact on access to care for Medicare’s most
vulnerable population, dual eligible beneficiaries. The results of our study will enhance our
understanding of how MIPS may influence care for men with prostate cancer and whether it
promotes inequities in the delivery of care. The findings from this study will directly inform
policymakers of potential gaps within the program so the policy may be improved in future iterations
to enhance patient care.

## Key facts

- **NIH application ID:** 10535234
- **Project number:** 1F32CA275021-01
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Avinash Maganty
- **Activity code:** F32 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $85,550
- **Award type:** 1
- **Project period:** 2022-07-15 → 2023-07-14

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10535234

## Citation

> US National Institutes of Health, RePORTER application 10535234, Impact of the Merit-Based Incentive Payment System on the Quality of Prostate Cancer Care (1F32CA275021-01). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10535234. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*