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The Future of Private Practice Under Value-based Care

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An increasingly frequent concern is that the Merit-based Incentive Payment System (MIPS) and value-based care in general could lead to the demise of private physician practices. With the prevalence of that concern comes pressure for private practices to join Accountable Care Organizations (ACOs), where groups of doctors and/or hospitals synergize to deliver coordinated care to Medicare patients. ACOs certainly have their benefits, but the risks of joining one need to be evaluated as well. An ACO may work for one orthopaedic practice but not for another. From my perspective, private practices, both small and large, will be able to thrive under MIPS. Here’s why:

  • First, the final ruling from MACRA has given physicians the ability to report with the ‘pick your pace’ model. The slow, phased introduction for MIPS gives practices a window of time to get on track. 2017 is the transitional year, giving practices time to identify processes and an EHR system that best fit their needs.
  • Second, CMS established flexible MIPS measurements based on practice size. (Small practices are typically considered to be those with ≤15 providers, and large practices have >15 providers.)
  • Third, if you have the right support from your vendors—especially your EHR system vendor—you will have a built-in MIPS intelligence platform, composite scoring, and support and advisory services to help you along the way.
  • Finally, the government has earmarked an extra $500 million for “exceptional performance” for each year of the first five years of MIPS. The right EHR system can direct and support you to achieve this exceptional-performance rating.

Ultimately, the decision to join an ACO or remain a private practice is a multifactorial one. You should consider the options available and how they will impact you, both in the short term and long term. Either way, value-based care is here to stay, and finding an EHR vendor with the best resources for your practice is a crucial component for success.

Jason Weisstein, MD, MPH, FACS is the Medical Director of Orthopedics at Modernizing Medicine. Read Dr. Weisstein’s other articles in this series including topics such as tips to excel under MIPS, data and analytics and specialized health registries.

OrthoBuzz occasionally receives posts from guest bloggers. This guest post comes from Jason Weisstein, MD, MPH, FACS. Click here to read the original article as it appeared on JB&JS OrthoBuzz. jb&js orthobuzz logo

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The Author

Jason Weisstein, MD, MPH, FACS