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More than 90% of doctors and other clinicians participating in Medicare's new payment system received bonuses in the first year of its rollout. That includes 71% who were "exceptional," according to a report from the Centers for Medicare & Medicaid Services.

The big picture: The goal of this system is to encourage doctors, nurse practitioners and others to provide better care.

  • But the Medicare Payment Advisory Commission believes this payment system "will not be successful" and "should be eliminated" as soon as possible, because of its complexity and because it's almost impossible to compare who is doing well. Clinicians choose their own measures to be graded on.
  • The financial carrots also are limited. Bonuses for "exceptional doctors" ranged between 0.3% and 1.9% in this first year, and some with "high" quality marks may get no bonus at all.

Go deeper ... Growing trend: Employers doling out bonuses instead of raises

Go deeper

Off the Rails

Episode 2: Barbarians at the Oval

Photo illustration: Sarah Grillo/Axios. Photo: Jim Watson/AFP/Getty Images

Beginning on election night 2020 and continuing through his final days in office, Donald Trump unraveled and dragged America with him, to the point that his followers sacked the U.S. Capitol with two weeks left in his term. This Axios series takes you inside the collapse of a president.

Episode 2: Trump stops buying what his professional staff are telling him, and increasingly turns to radical voices telling him what he wants to hear.

President Trump plunked down in an armchair in the White House residence, still dressed from his golf game — navy fleece, black pants, white MAGA cap. It was Saturday, Nov. 7. The networks had just called the election for Joe Biden.

Fringe right plots new attacks out of sight

Illustration: Aïda Amer/Axios

Domestic extremists are using obscure and private corners of the internet to plot new attacks ahead of Inauguration Day. Their plans are also hidden in plain sight, buried in podcasts and online video platforms.

Why it matters: Because law enforcement was caught flat-footed during last week's Capitol siege, researchers and intelligence agencies are paying more attention to online threats that could turn into real-world violence.

Kids’ screen time up 50% during pandemic

Illustration: Sarah Grillo/Axios

When the coronavirus lockdowns started in March, kidstech firm SuperAwesome found that screen time was up 50%. Nearly a year later, that percentage hasn't budged, according to new figures from the firm.

Why it matters: For most parents, pre-pandemic expectations around screen time are no longer realistic. The concern now has shifted from the number of hours in front of screens to the quality of screen time.

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