MACRA may lead to private practice's fall — 5 insights

Practice Management

Healthcare's trend toward value-based care is changing the way physicians are reimbursed, which may have a negative impact on independent physicians, according to

CMS proposed the Medicare Access & CHIP Reauthorization Act of 2015, where 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.


Niran Al-Agba, MD, detailed why MACRA may be the end of private practice.


Here are five insights:


1. 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.


2. The survey also found 59 percent of physicians in practices with less than 25 clinicians expect to receive a performance penalty as high as 4 percent under MACRA.


3. Dr. Al-Agba said the value-based care should emphasis patient engagement, rather than determining a score based on the number of checked boxes on a computer screen.


4. Although Dr. Al-Agba says value may be difficult to quantify, she argues value-based care will yield lower reimbursement for physicians, thereby leading to the end of private practice.


5. Dr. Al-Agba argued CMS does not account for the work physicians put into patient care, including time spent discussing treatment options with patients. Rather, Dr. Al-Agba said, "CMS misses the forest for the trees. They believe saving on the office visit altogether is better overall."


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