Planning for MACRA and Consulting Help

[TheGipper]

Veering a little off topic from finance topics to policy and reimbursement, but I figure with all the smart folks on this forum, it is worth posting and discussing.

MACRA (Medicare Access and CHIP reauthorization Act) looks to be a game-changer and concern for smaller private practices in particular.  With the proposed rule soon to be finalized,

1) Have any of you given serious thought to which pathway you will choose:

MIPS (Merit-Based Incentive Payment System), which based on how quality measures are scored may increase or decrease your reimbursement by 4-9% increasing from 2019-2022 on.

APM (Advanced alternative payment model).  Seems challenging for most smaller groups to obtain.

2)  Does anyone plan on paying a consulting firm to guide them through this?  If so, who are you using and what are you paying?

[Otodoc]

3 doc group here.  APM impossible for us.  MIPS is going to be terrible.  there is no good way to prove quality yet, especially in a small field like mine,.  We as doctors, and even our academy, constantly debate what constitutes "quality", or "cost effective" care.  No way we can continue to afford the costs to comply with all these standards and rules, which they then change based on whims of bureaucrats.  we are trying to get bought by a hospital and let them deal with those headaches.  sad but true.  i dont see any way small groups like ours in very high medicare and medicaid areas can continue to remain private.

[Hatton]

This kind of crap is making it impossible for small practices to survive.  I am close to retirement so I will not be hiring any consultants.  I have very low overhead so I am working 3 days a week and doing ok but I have decided to retire when the next shoe drops.

[VagabondMD]

Here's my MACRA plan: I plan to get out before it takes effect. My knees and ankles are getting sore from jumping through all these ************************ hoops, and it is having a negative effect on my trail running!

[TheGipper]

Very helpful advice guys. Anyone one who is not planning on getting out of the race have any thoughts on value of consultants here?