The past year has seen plenty of change in the world of practice management, with more on the horizon. Looking ahead, what can physicians anticipate for 2017? Here are seven developments in the coming year to consider.
1. The Affordable Care Act and congressional action. Some type of congressional action with the Affordable Care Act (ACA) seems certain because of Donald Trump’s election and Republicans controlling the Senate and House, but the results may not bring dramatic change.
"The GOP has made 'repeal and replace' a battle cry and they will certainly do what they can to make good on that promise with the ACA, at least in some fashion," says Richard Heller, a radiologist and vice president of clinical services & national director of pediatric radiology at Radiology Partners in El Segundo, Calif. However, given Republicans’ lack of a filibuster-proof majority in the Senate, action that weakens rather than eliminate the ACA may be more likely, he says.
Heller notes that unlike the ACA, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) garnered bipartisan and bicameral support, passing in the Senate by a vote of 92 to 8. Significant legislative changes for MACRA do not seem to be on the horizon.
2. New Data and Deadlines. Of course legislation is only a starting point; the regulations that follow are often where the rubber meets the road. Fortunately, going into next year physicians will find some relief in the final rule for MACRA, announced by CMS acting administrator Andy Slavitt in October.
"There's a lot of angst in the physician community about the implementation of this program," says Gerald Maccioli, an anesthesiologist and chief quality officer for AmSurg/Sheridan Healthcare, a management and support service for surgery and outpatient centers based in Plantation, Fla. "To address this anxiety, rather than giving physicians a hard start date with penalties applied, CMS has modified the phase-in year of the program with three options."
The first option for year one of MACRA's Merit-based Incentive Payment System (MIPS), one of the two pathways providers can take for this program, allows for a test year of the program. Physicians can submit some data during the calendar year, while the second option allows partial year submission with some opportunity for bonus. The third option is for full-year participation with an opportunity for a larger bonus. Each of the three choices comes without penalty. A fourth option is to participate in an Advanced Alternative Payment Model (APM) such as Medicare Shared Savings Track 2 or 3 in 2017. Receiving enough Medicare payments or seeing enough Medicare patients through the Advanced APM model leads to a 5 percent incentive payment in 2019.