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7 Predictions for Practice Management in 2017 : Page 2 of 3

7 Predictions for Practice Management in 2017 : Page 2 of 3

 "The flexibility offered by the final rule is a real relief in the general medical community," Maccioli says.

At the same time, physicians should not delay efforts to meet the new requirements, according to Lenexa, Kansas-based L. Patrick James, a pathologist and chief clinical officer of health plans and policy, and medical affairs, for Quest Diagnostics.

"If they haven't already, physicians should make it a priority to develop a MACRA implementation plan that takes into consideration new quality and risk parameters," he says.  "It's also important to understand that documentation will be critical as we move from volume to value." 

He adds that physicians must now know the quality and risk measures that apply to each individual patient under relevant value-based care models.  To avoid burnout and allow them to benefit from new financial incentives, physicians and staff practices will need to find ways to deal with growing complexity.

3. Shifting payments.  Physicians and staff need to prepare for significant payment changes in 2017, according to Kate Othus, a member of the National Society of Healthcare Business Consultants based in Portland, Ore.   From  evolving government practices to higher deductibles, rising medication costs and other private sector realities, practices may face new cash flow challenges.

 "The era of upside-only Medicare risk is ending," she says.  Othus notes that MACRA's initiatives will drive transparency of high-quality metrics, which may affect the competitive advantage of a practice in the marketplace and eventually cash flow.

"Further, payment liability continues to burden physician offices," she says. "Working to position the practice to handle these high-deductible payment liabilities from patients is a key to effectively managing cash flow."

Heller adds that going beyond Medicare, Medicaid is transitioning to "Managed Medicaid" using Managed Care Organizations (MCOs), which are groups that provide coordinated health services across member healthcare professionals, such as an independent physician association. "These will increasingly turn to value-based payment models as opposed to traditional fee-for-service," he says.

4. Added regulation.   While ACA and MACRA may be the most significant sources of new regulations, others may also enter the picture. Public attention to problems such as drug abuse may also drive new law or regulations.

"There will be continued scrutiny on increasing access to chemical dependency treatment and increasing reimbursement to providers for such treatment," says Christianna Finnern, an attorney with Minneapolis-based law firm Winthrop & Weinstine. "The opioid addiction epidemic will continue to be a major national issue, and both the federal and state governments will continue to find ways to try to limit access to drugs while increasing access to treatment and prevention."

5. Changing insurance scene.  Another challenge to be faced in the next year will be rising premiums and deductibles, says Linda Girgis, a family doctor in private practice in South River, N.J. 


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