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.
AAPS executive director Jane M. Orient, MD, said, “It is impossible to practice medicine under this rule, for ethical and practical reasons. The rule makes it impossible to protect confidentiality, and one is in a constant conflict of interest: What is best for the patient may be bad for the financial viability of the practice. It would take a dedicated team of legal specialists to even attempt compliance. Full compliance is probably impossible even with such a team, which is beyond the means of a small practice.”
Here are five points:
1. Almost 33 percent of physicians in small practices predict MACRA will result in small practices merging into larger groups.
2. 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.
3. CMS initially estimated most clinicians in groups of 24 or less will endure a penalty in 2019. Initial estimates anticipated CMS’ MIPS would provide bonuses or penalties to nearly 102,788 solo practitioners. Of that figure, nearly 87 percent would face MIPS penalties in 2019.
4. Due to many concerns, 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.
5. Dr. Orient implored physicians to not participate in Medicare or any other program that “subjects them to this rule.”
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