A RECENT SURVEY SHOWED THAT ONLY 18% OF U.S. PHYSICIANS HAVE EVEN A BASIC UNDERSTANDING OF THE NEW PAYMENT REGULATIONS UNDER MACRA. FOLLOWING IS A SIMPLE PRIMER TO HELP YOU BE IN THE KNOW.

Under MACRA, new CMS regulations are now in place to further shift reimbursements from fee-for-service for a strict value-based model. Ramp-up began in 2015 and will fully eliminate FFS as we know it by 2021. To be reimbursed, physicians must either participate in a Merit Based Incentive Payment System (MIPS) or be part of an Advanced Alternative Payment Model (APM), like an ACO.

Although this shift represents a first step to a fresh start for a better, smarter Medicare that fosters healthier patients and a sustainable ecosystem, it will have significant and long-reaching impact on independent providers.

MIPS, in particular, represents a unique threat, being likened by experts as “The Wild West” where independent providers will be left to fend for themselves in an unpredictable and inhospitable environment.

In contrast, MACRA does not change how any particular APM functions or rewards value. Instead, it creates extra incentives for APM participation.

Bottom Line

Under MIPS – Earning Ceilings and Likely Loss of Income – Odds stacked against independent providers with 87% of solo practitioners projected to incur ongoing income penalties of up to 9% by 2022

APM Model under a Premier ACO – Zero Negatives and No Earning Ceilings – Premier leverages regulations in your favor and mitigates risk, provides stepwise, effective programs and technology to help you generate nearly uncapped income, including an additional 5% lump sum bonus NOT available under MIPS.

Premier is dedicated to anticipating, demystifying and adapting to shifting regulations like these for the benefit of Premier Partner Physicians. To learn more about how we can help you secure your future and maximize practice income under current and future regulatory changes, we encourage you to contact us at engage@premierphc.com.