The QualityIQ simulation platform incorporates real-time evidence-based feedback and gamified peer benchmarking to help primary care physicians bring care decisions into alignment with the latest best practices in the Merit-Based Incentive Payment System (MIPS). To assess the effects of the novel web-based patient simulation tool, researchers conducted a cross-sectional analysis with a national sample of U.S. physicians who were randomized to continuing medical education (CME) and non-CME study cohorts. Participants "cared" for eight weekly cases that covered typical primary care scenarios. QualityIQ engagement was strong and scalable, with 75% of participants (61 non-CME and 59 CME) completing at least six of eight cases. Evidence-based clinical decisions showed substantial improvement across multiple conditions, including diabetes and osteoarthritis. MIPS-related quality measures like diabetes eye examinations, depression screening and asthma medications also improved. CME availability did not boost enrollment, but physicians who were offered CME credits were more likely to complete at least six cases. High participation rates were observed across multiple exposures, with 66% of participants completing at least half the weekly cases. The availability of CME and maintenance of certification did not affect enrollment or performance in the cases, the researchers concluded. "We believe that the proliferation of web-based CME opportunities means that fewer physicians need to seek out CME opportunities," the authors write. They also suggest that QualityIQ "may be of interest to health systems, payers, policymakers, patient advocacy groups and life science companies looking to collaborate with providers in practice change efforts to improve the quality, value and consistency of care."