Concern grows over doc readiness for Quality Payment Program

Register now

A rule recently issued for the Quality Payment Program has several provisions intended to make it easier for smaller physician practices to participate in the Advanced Alternative Payment Model or the Merit-based Incentive Payment System initiatives.

Among those efforts will be continued support for physician groups that need help with the information technology that will move them into the new quality and value paradigm.

In the rule, the Centers for Medicare and Medicaid Services says its aiming to increase quality of care, which could enhance physicians’ reimbursement under Medicare.

“The support of small, independent practices remains an important thematic objective for the implementation of the Quality Payment Program and is expected to be carried throughout future rulemaking,” CMS notes in the rule.

For example, QPP offers $100 million in funds for technical assistance for providers through contracts with regional health collaboratives and other organizations, with the help primarily being targeted at practices with 15 or fewer clinicians, particularly those in rural or medically underserved regions, and practices with low MIPS final scores.

Also See: Physicians generally aren’t ready for the Quality Payment Program

CMS is permitting these physicians to band together in “virtual groups” to spread the financial risk and pool their reporting to CMS, says Dan Golder, a principal at Impact Advisors, a consultancy.

If a particular physician misses a quality measure on MIPs, such as half of patients with diabetes not getting a foot exam, being in a pool with other clinicians will raise up that physician’s score, Golder says. If the physician isn’t in a virtual group and misses enough foot exams, that could impact his quality scores and reimbursement.

Unfortunately, CMS is very late in issuing the rule, and time is running out for physicians to learn about participating in the program and also to prepare for the transition.

“The rule is more than 1600 pages long, and the regulations are so burdensome that doctors might read a summary, but will they take the time to learn about it?” Golder asks.

The CMS rule is to be published on November 16 , but the first reporting period starts January 1. That means electronic health record vendors have to recode and test software during the rest of 2017, and providers have to change workflows, with no consideration by CMS over how realistic both vendors and providers can be ready by January.

“A lot of provisions in the rule are good, but (there is concern about whether) vendors and providers can be ready in time,” Golder says.

For reprint and licensing requests for this article, click here.