Abstracts from the Abstracts from the Mid-Atlantic Section of the AUA 2021

MA-AUA 2021 Abstracts Moderated Poster Session 5: Surgical Technology/Imaging Urology Practice Scores in the Era of the Merit-based Incentive Payment System R. Alam, M. Clifton, M. Han Johns Hopkins University School of Medicine, Baltimore, MD, USA Introduction and Objective: In the era of value-based payment, there has been a shift toward integration of physician practices into health systems with multispecialty entities. It is unknown how urologic practices have been impacted by the recent implementation of theMerit-based Incentive Payment System (MIPS). We describe the MIPS performance scores of urologists and investigate the evolution of practice patterns over time. Methods: Urologists were identified in the 2018 MIPS performance score database. Each clinician was classified by participation status, which is defined as enrollment in MIPS as an individual practitioner, group practice, or alternative payment model (APM). The overall MIPS score is comprised of four categories with a maximum score of 100 points: quality, promoting interoperability (PI), improvement activities (IA), and cost. Comparative statistics were performed using Tukey’s honest significance test and chi- square analysis. Results: A total of 9055 urologists were included with the following average scores: quality 82.5, PI 88.9, IA 37.3, cost 74.4, and overall 86.9. The figure shows each individual score stratified by participation status. There were statistically significant differences among the three groups (P<0.001) in each category except for cost. Group practices scored higher than individual practitioners; APMs often scored even higher. Individual practices were more common among urologists who graduatedmedical school between 1950 and 1989, whereas group practices were more common among those graduating 2010 and beyond; APMs were most common in the 1990s and 2000s (P<0.001). Conclusions: Urologists who participated as a group practice orAPMappear to have transitioned to the MIPS criteria with greater success than individual practitioners. Urology practices have evolved over time, likely as a response to meet increasingly stringent standards of care. MP5-10 HOLEP Perioperative Outcomes Using Three Different Holmium Laser Technologies in a Community Hospital Setting M. Li 1 , A. Brown 1 , N. Russo 1,2 , J. Johannes 1 1 Lehigh Valley Health Network, Allentown, PA, USA; 2 University of South Florida Morsani College of Medicine, Tampa, FL, USA Introduction and Objective: Transurethral resection of the prostate is the gold standard treatment of Benign Prostatic Hyperplasia. Holmium laser enucleation of the prostate (HoLEP) has demonstrated superior perioperative and long-term outcomes. Recent advances in laser technology have improved treatment times, hemostasis, and length of stay. We examined the perioperative outcomes of three generations of lasers: Traditional 100W HoLEP, Moses Pulse 120H (Moses 120), and Moses Enucleation of the Prostate (MoLEP). Methods: HoLEP was performed by a single surgeon in 140 patients using the Traditional 100W HoLEP, Moses 120, and MoLEP with a modified two- lobe technique. Patient characteristics, pre-, peri-, and post-operative data were recorded in a prospective database. Results: Patient characteristics and preoperative values were similar between cohorts (Table 1). A decreased total length of surgery (mean = 64 min, p = 0.03), resection time (mean = 43 min, p = 0.019), length of stay (mean = 10 hours), and an increased same-day discharge (mean = 88%) was seen in the MoLEP cohort. Thirty day readmission was highest in the Traditional 100W HoLEP cohort at 4, with 2 requiring reoperation for genitourinary cause. Readmissions forMoses 120 andMoLEPwere 1 and 2 respectively, with 1 from each necessitating reoperation.All returns to operationwere due to hematuria. Conclusions: MoLEP demonstrated superior outcomes, including shorter operative times and a higher percentage of patients discharged same- day compared to Traditional 100W HoLEP and Moses 120. Additionally, readmissions were decreased inMoses 120 andMoLEPwhen compared with Traditional 100WHoLEP. This is prospective evidence HoLEP using MoLEP improves outcomes over other holmium laser technology. MP5-09 37