With the recent changes regarding reimbursements to physicians for medical treatment of patients, moving away from a fee-for-service payment system to a value-based payment system, many are left speculating what this means for smaller physician practices. Will there be room for smaller practices or will the system benefit larger practices leaving the others behind?
A debate over whether the Medicare Access and CHIP Reauthorization Act (MACRA), the rule regarding physician payment passed by Congress in 2015, would negatively affect solo medical practices was raised due to the Centers for Medicare and Medicaid Service’s (CMS) estimates that it would lower payments for smaller healthcare organizations.
MACRA repealed the sustainable growth rate (SGR) formula, shifting the focus to rewarding quality over quantity. It “replaces Medicare’s multiple quality reporting programs with a single ‘MIPS’ program that makes it easier for physicians to earn rewards for providing high-quality, high-value health care,” according to a summary report provided by the American Medical Association (AMA).
Small medical practices
The report by the AMA discovered that single physician’s offices have significantly declined from 1983 to 2014. However, in spite of a decline from 41 percent to 17 percent, 4 out of 10 physicians still work with less than five doctors in a single practice, especially in rural regions. Practices with more than 25 practicing physicians rose from 5 percent to 20 percent.
The study attributed this rising trend to several factors. These included retiring physicians are not being replaced, preferences of younger physicians for predictable income and stable work-life balance, and solo practices tend to be more demanding. Healthcare practices feel the pressure to grow and compete with one another.
This is something the CMS hopes to rid the industry of with the Medicare Shared Savings Program’s (MSSP) Accountable Care Organizations (ACOs) incentive program for producing value-based care by coordinating with one another instead of in competition.
Helping small practices secure a future
In rural areas, you won’t find exceedingly large medical organizations especially because there is no need for them. Small practices often do not have advanced technologies necessary to accurately collect, manage, and report the information to maintain the required transparency demanded by insurers and the government. Maintaining an end-to-end revenue cycle management proves challenging for them. Outsourcing your medical billing to professionals is a viable option because they can help you adapt and secure your future.
Several recommendations have been given to help small practices adjust to the implemented changes. These suggestions include joining a network for resource sharing, improvements in health information technology, providing technical support, and developing a payment model that includes upfront grants or loans to invest into required infrastructure.
At Rev-Ignition, we work with your healthcare organization to improve your productivity, reduce overhead expenses, and increase revenue. Speak with a professional at (844) 297-9944.