AMA Pres: MACRA Has Been Made Favorable for Small Practices

January 26, 2018

In this podcast, AMA President David O. Barbe, MD talks about the accommodations that CMS has made towards small practices in MACRA.

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The 2018 reporting year for the CMS Quality Payment Program (QPP) has arrived.

Some categories in the QPP's Merit-based Incentive Payment System (MIPS) pathway are based on full-year reporting, which means physicians eligible for the program cannot hold off on compliance any longer. They must understand the intricacies of this year's requirements, says American Medical Association President, David O. Barbe, MD. For instance, this year, the cost category of MIPS counts, unlike last year.

"[Cost] was 0 percent [of the total MIPS score] in 2017. It's now 10 percent in 2018…that was taken from the quality category, which has gone from 60 percent of the MIPS score to 50 percent," Barbe, who is also a family physician in Mountain Grove, Mo., says on the podcast. While MIPS doesn't have the "pick your pace" flexibility available last year, he says it should be an obtainable plateau for small practices.

"There are opportunities for small practices, including the opportunity to form virtual groups, five bonus points for groups with 15 eligible providers or fewer….there's also favorable scoring in the quality category for small practices."

There are other accommodations for small practices, including the fact that CMS expanded the low-volume threshold for exclusion from MIPS reporting to groups with less than $90,000 in Part B allowed charges or fewer than 200 Part B beneficiaries. All this, Barbe says, makes MACRA ''about as favorable as it can be for small practices."

Later in the podcast, Barbe talks about why it's not a good idea to cut the MIPS program and start over, as the Medicare Payment Advisory Commission has advised . "We believe it's way too soon to abandon the program altogether. We still see opportunities for improvement and will work with CMS on those…but we're not ready to declare this a program that can't work or won't work for doctors or patients," he says.

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