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June 17, 2016 | Small Independent Practices and MACRA: Forecasting the Future

As healthcare prepares for its upcoming switch to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) payment system and reimbursements based on value-based care, concerns continue to grow for small physician practices who are trying to best understand how these transitions will affect their business.

For many small practices, the new reporting requirements, which will take hold in 2018, are expected to stretch available resources and possibly negatively affect reimbursement rates and financial success.

Supporting this finding, a report released this week from Blackbook Research polled 300 physician groups with five or fewer clinicians, and found that 67% of these practices believe their independence will end with MACRA.

Key takeaways from the survey include:

• 89% of solo practices plan to minimize Medicare volume to avoid filing quality and clinical practice improvement reports or cost performance reports to CMS;

• Before 2019, 78% of independent primary care physicians expect to join a bigger group or integrated delivery network (IDN) to access reporting and revenue cycle tools and support;

• Among practices with 10 or fewer practitioners, 63% remain unsure which health information technology solutions and products meet their needs for meaningful use, clinician usability, interoperability, and coordinated claims and billing.

While this forecast reflects just how much apprehension is associated with MACRA, it remains highly unlikely that the AMA and CMS will stand by and let these providers go out of business. Primary-care physicians are essential gatekeepers for Medicare patients and as takeaway #1 shows, minimizing the number of at-risk patients treated by PCPs is a surefire way to accrue higher healthcare costs and negative outcomes.

Just yesterday, this great piece in Forbes examined comments from Andy Slavitt, administrator for the CMS, where he calls on all physicians to provide input and share concerns about MACRA.

In particular, Slavitt said this of the MACRA transition:

“Things won’t change overnight. The first year of this new program will hit bumps as new policies run into the realities of everyday medicine. Systems will need to adapt to your needs.”

As explored on our blog, there is a myriad of resources available for physicians looking to understand how they can best transition to value-based care. Further, for providers looking to provide exemplary – and streamlined – care to their Medicare populations during this time of change, technologies like Wellbox can help increase revenue without accruing additional implementation and operating costs.

MACRA is on its way, but with the CMS’ pledge to incorporate physician input and provide full support, along with the increasing volume of high-incentive programs being created, it may be too early to interpret the Blackbook survey as signaling the end of small practices.