Small Practices Forging Ahead in Value-Based Care

There is a lot of skepticism in the physician world on whether or not "value-based care" — where providers are reimbursed based on quality measures, rather than quantity — can work.

In an upcoming, yet-to-be-released survey fromPhysicians Practice, more than 50 percent of physicians (1,314 were surveyed) said value-based care was a good idea in theory, but difficult in practice. A smaller group, approximately 20 percent, went so far to say that it was a bad idea that would never succeed. Only 6 percent of respondents said it was a good idea and good for patients.

Yet despite the fact that value-based care may not be winning the hearts and minds of physicians across the country, CMS is attempting to do just that before those doctors have to get on board. The agency recently proposed a rule to implement the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), mandating two tracks for physician reimbursement — the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APMs).

Most physicians will fall under the former, where they'll be scored on quality measures, usage of technology, clinical improvement, and cost utilization. APMs require participation in Medicare-based payment models such as accountable care organizations (ACOs) and Patient-Centered Medical Homes (PCMHs). In the past few months, CMS has spent a copious amount of time to get physicians on board, through webinars, speeches from officials at professional meetings, and more.

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