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    Small practices likely to be ‘losers’ under MACRA

    In 962 pages of the proposed rule for the implementation of the Medicare Access and Summary CHIP Reauthorization Act of 2015 (MACRA), it is a single chart that speaks volumes about the potential future for smaller U.S. medical practices.

    Tucked away on page 676 of the proposed rule outlining the details of the Merit-based Incentive Payment System (MIPS), CMS estimates that 87% of the nation’s solo practices (nearly 103,000 physicians) will face a penalty in 2019, the first year of the program, to the tune of $300 million. The news is equally as pessimistic for practices of two to nine physicians (an estimated 124,000 physicians) who could see penalties to the tune of $279 million

     

    Related: 7 things physicians need to know about MACRA proposed rule

     

    If the rule stands as currently drafted, Ingrid Lund, PhD, practice manager for research and insights at The Advisory Board Company, says MACRA could profoundly change the care delivery landscape.Ingrid Lund, PhD

    “There are winners and losers [in MACRA] and smaller practices are more likely to be the losers,” Lund told Medical Economics. “It appears the proposed rule would create a penalty system where the big guys [larger practices] will be funded by the little guys.”

     

    Further reading: Medical societies pleased with MACRA rule

     

    Lund, who works primarily with independent medical groups in her work with the consulting firm, says that it is up to these smaller groups to take advantage of the comment period (through June 26) to push to change the winners-losers dynamic under MACRA and maintain the strength of independent practices.

    Next:  “Independent groups are going to feel more vulnerable"

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    • PETERBMALENCH
      as expected, "affordable and quality value care" will kill the small independent practices, and the large ones will spend more to comply with MACRA, or whatever acronym system is next. In our area we are already seeing more doctors not accepting Medicare and this will only increase in the future.

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