Is consolidation the future for small practices in the wake of MACRA?

Practice Management

A Medscape Medical News Survey found almost 33 percent of physicians in small practices predict CMS' Medicare Access & CHIP Reauthorization Act of 2015 will result in small practices merging into larger groups.

Under MACRA, physicians can participate in the Merit-Based Incentive Payment System or the Alternative Payment Models. MIPS consists of a weighted score of quality, resource use, meaningful use and practice improvement scores. Physicians have the opportunity to receive financial bonuses if they obtain good quality outcomes. However, many may face penalties if they fail to meet CMS' requirements.


Here are five findings:


1. More than half (59 percent) of physicians in practices with less than 25 clinicians expect to receive a performance penalty as high as 4 percent under MACRA.


2. Merely 9 percent of physicians in groups with less than 25 clinicians anticipate a bonus.


3. Twelve percent of physicians in small practices expect zero compensation change under MACRA.


4. CMS initially estimated most clinicians in groups of 24 or less will endure a penalty in 2019. Initial estimates anticipated CMS' Merit-Based Incentive Payment System would provide bonuses or penalties to nearly 102,788 solo practitioners. Of that figure, nearly 87 percent would face MIPS penalties in 2019.


5. In May, Acting CMS Administrator Andy Slavitt said small practices can succeed as well as larger practices in regard to CMS' MACRA. MACRA allots $100 million over five years for technical assistance to practices with 15 or fewer clinicians, particularly in rural and underserved areas.


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