Medicare's new payment model will greatly influence solo physicians and small groups who may endure steep penalties, according to Medscape.
Starting 2016, CMS's Medicare Access & CHIP Reauthorization Act of 2015 will replace the current Meaningful Use, Physician Quality Reporting System and Value-Based Payment Modifier. MACRA will reward physicians based on their ability to enhance patient outcomes while reducing costs.
Physicians have the option to participate in the Merit-Based Incentive Payment System or the Alternative Payment Models under MACRA. Most physicians will initially operate under MIPS, which consists of a weighted score of quality, resource use, meaningful use and practice improvement scores.
Here are six things to know:
1. The MIPS formula will give nearly 412,000 physicians bonuses as high as 4 percent in 2019.
2. However, nearly 346,000 physicians will endure penalties that year. Of those physicians, most are in practices of one member to 24 members.
3. CMS estimates it will provide MIPS bonuses or penalties to nearly 102,788 solo practitioners. Of that figure, nearly 87 percent will face MIPS penalties in 2019.
4. For practices comprised of 2 members to 9 members, nearly 69.9 percent will face penalties.
5. On the other hand, for practices with 100 members or more, CMS estimates they will only issue penalties to 18.3 percent of large practices.
6. Of the nearly 761,343 clinicians eligible for MIPS, CMS estimates they will penalize 45.5 percent, and reward 54.1 percent.
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