Lawmakers Hear Warnings About Toll MACRA Could Take On Small Practices
As the draft rule on this new Medicare physician payment structure is being finalized, a group of GOP physician-lawmakers expresses alarm to the Centers for Medicare & Medicaid Services. Other coverage details the role that commercial insurers have in slowing the trend toward value-based payment models and the "predicament" faced by Wills Eye Hospital when it comes to Medicare.
GOP Lawmakers Say MACRA Could Kill Small Practices And Fuel Consolidation
Republican lawmakers are warning the CMS that if its draft rule on the new physician payment framework is finalized as is, small practices may close their doors, leading to more consolidation and higher healthcare costs. A group of Republican physicians in Congress wrote to the CMS just weeks before a final rule is expected. When MACRA goes live in 2019, it promises bonuses for top-performing doctors and clinicians and negative incentives for underperformers on a variety of measures, especially quality of care. (Dickson, 10/12)
Providers Say Commercial Payers Are Unwilling To Share Risk
While healthcare providers are speeding ahead with implementing value-based payment models to reduce admissions and save costs, some slow-to-adapt commercial insurers are hindering progress, according to a survey of health system executives. Because insurers in many states have been slow to form value-based payment agreements with integrated delivery systems and clinical networks, 66.7% of hospital C-suite leaders are becoming more interested in starting or pairing up with a provider-owned health plan rather than waiting on insurers to partner up, according to the survey released Wednesday by healthcare group purchasing and quality consulting firm Premier (Livingston, 10/12).
The Philadelphia Inquirer:
Wills Eye's Medicare Predicament
Wills Eye Hospital's top East Coast rivals in Miami, Baltimore, and Boston operate as hospitals under Medicare, even though most of their patients are outpatients. Wills, despite its name, is not a hospital under Medicare. The Center City institution gave up that designation in July 2006 when it sold its inpatient business to Jefferson, operating instead as an ambulatory surgery center at Eighth & Walnut Streets. Now, Wills is fighting to get that hospital certification back, after completing a $6.5 million renovation three years ago that included a four-bed inpatient unit. (Brubaker, 10/12)