Top 10 challenges facing physicians in 2017

http://medicaleconomics.modernmedicine.com/medical-economics/news/top-10-challenges-2017

2016 was a challenging year on many fronts for healthcare providers.

Physicians have just started to digest the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and its changes to physician reimbursement. A long presidential election finally reached its conclusion, but the consequences of a Republican Congress and President-elect Donald J. Trump for U.S. doctors and patients remain unclear. And running a private practice did not get any easier. Balancing the need to deal with patients who won’t listen or won’t pay while also seeking positive patient satisfaction scores remains a daily struggle for many. 

These were just some of the challenges physician readers told Medical Economics they experienced this year and anticipate continuing for the foreseeable future. 

For the fourth consecutive year, Medical Economics reveals its list of obstacles physicians will face in the coming year and, more importantly, how to overcome them. For this latest presentation, we asked readers to tell us what challenges they face each day and where they needed solutions.

Here are their responses, starting with the biggest challenge of the coming year.

How doctors can overcome payment obstacles in 2017

http://medicaleconomics.modernmedicine.com/medical-economics/news/how-doctors-can-overcome-payment-obstacles-2017?utm_source=TrendMD&utm_medium=cpc&utm_campaign=Medical_Economics_TrendMD_0

 

Survey: 70% of medical groups worried about MACRA implementation

http://www.beckershospitalreview.com/finance/survey-70-of-medical-groups-worried-about-macra-implementation.html

Image result for macra implementation

Almost three-quarters of employed medical groups are concerned about implementation of the final Medicare Access and CHIP Reauthorization Act rule, according to The Advisory Board’s survey of the Medical Group Strategy Council.

The Advisory Board said it recently surveyed a group of 30 employed medical groups to determine their concern about MACRA and see how they’re adjusting to the changes MACRA will cause.

Here are five survey findings.

1. Seventy percent of respondents are “concerned” or “totally freaked out” by MACRA. Of the remaining respondents, 20 percent are “confident,” while 10 percent are “ambivalent,” the survey found.

2. The MACRA final rule, a landmark payment system for Medicare physician fees that replaces the sustainable growth rate formula, includes two pathways for provider participation: the Merit-Based Incentive Payment System and the Advanced Alternative Payment Model. According to the survey, 70 percent of respondents anticipate participating in MIPS, while the remaining 25 percent predict they will fall into the APM category.

3. Only half of the medical groups that believe they will participate in MIPS expect to be prepared to report data for the entirety of 2017, according to the survey. Another 21 percent anticipate choosing the partial-year option to be eligible for the smaller positive payment adjustment, and 29 percent of respondents planning to “test the program” by reporting nominal data to avoid the negative payment adjustment.

4. The Advisory Board said 58 percent of survey respondents identified MACRA as the driving force for consolidation efforts in their markets.

5. However, the other 42 percent of respondents have not observed MACRA affecting consolidation decisions in their markets, The Advisory Board said. “This could be a result of the additional support for small practices CMS included in the final rule. But we’re still in the early stages of MACRA implementation, so this may change during the coming year,” The Advisory Board added.

Unintended Consequences

http://altarum.org/health-policy-blog/unintended-consequences

Altarum InstituteAltarum Institute

How does it feel knowing the clinical decisions our physicians make affect their pocketbook? MIPS, or the Merit-based Incentive Payment System, is now the law of the land. MIPS attempts to incentivize physicians based on quality measures, use of electronic health records, practice improvement approaches and cost of care. The Centers for Medicare and Medicaid (CMS), is tasked with working out the details of the program, which aims to take us from a system where physicians are incentivized to “do something” to patients to one in which “quality” is the predominate goal.

Here’s my quandary: As a Geriatrician, I have practiced a lower cost approach to care my whole career. I try to avoid acute hospitalization, medications and procedures in my frail older patients. Why?  Because my experience, as well as a growing body of evidence-based literature, supports this approach. I should be wholeheartedly embracing this new approach to physician incentives. So, why do I feel sick when I think about it?

Eleven ways MACRA will impact your business

http://managedhealthcareexecutive.modernmedicine.com/managed-healthcare-executive/news/eleven-ways-macra-will-impact-your-business?GUID=A13E56ED-9529-4BD1-98E9-318F5373C18F&rememberme=1&ts=24082016

The Medicare Access and CHIP Reauthorization Act, known as MACRA, is one of the most significant payment changes since Medicare’s inception in 1965.

“Physicians and other clinicians payments will be at risk, beginning with a plus or minus swing of 4% in 2019, that increases to plus or minus 9% by 2023,” says Chester A. Speed, JD, LLM, vice president, public policy, AMGA.

To be successful under MACRA, providers will have to consider the clinical, financial and cultural changes they need to make to do well under risk, according to Speed.

“And while providers can rightfully say they’ve seen this before in the 1990s, risk, or value-based payments are now written into law and they are here to stay,” he says.

What impact will MACRA have on your organization? We asked experts to tell us.

Pay-for-Performance: Will the Models Provide Value?

http://www.healthleadersmedia.com/quality/pay-performance-will-models-provide-value-0?spMailingID=9166254&spUserID=MTMyMzQyMDQxMTkyS0&spJobID=960513787&spReportId=OTYwNTEzNzg3S0

In theory, paying for performance makes logical sense, says Ashish Jha, MD, MPH, director of Harvard’s Global Health Institute. But eliminating pay-for performance programs isn’t the answer, he says. Instead, an overhaul is necessary.

New Health Policy Brief: Medicare’s New Physician Payment System

http://healthaffairs.org/blog/2016/04/22/new-health-policy-brief-medicares-new-physician-payment-system/

Health Policy Brief

http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=156

Payment Reform: What’s at Stake for Cath Lab?

http://www.healthleadersmedia.com/leadership/payment-reform-whats-stake-cath-lab

Cath Lab Procedure Room

Although newer payment models will continue to evolve over the next few years, interventional cardiology has made small gains recently by becoming a specialty recognized by the Centers for Medicare & Medicaid Services.