Medicare Access and CHIP Reauthorization Act

As Medicare continues to roll out new regulations and reimbursement policies, Physicians are bracing for more change.  Starting in 2017, Physicians will begin reporting and being measured by new proposed Quality and Standard measures.  Starting in 2018, Medicare will begin paying physicians under the Quality Payment Program, (QPP), a new reimbursement formula for physicians that combines several existing quality programs.

“We believe Physicians have weathered the last five years pretty well, but at a great cost.  And now, Physicians must deal with the looming Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, which we believe, has the potential to be far more tumultuous.

In recent weeks, the Department of Health and Human Services (HHS) has made several important announcements related to the Quality Payment Program, which has been proposed to implement the new, bipartisan law changing how Medicare pays Clinicians, under the MACRA guidelines.

And on the commercial side of the Primary Care Practice, Physicians are seeing a troubling trend . . . . some commercially insured patients can’t afford ongoing care for chronic conditions because of out-of-pocket costs.  Physicians are telling us, “My patients come in for benefits defined under the essential benefits of their plan; preventive care, mammograms, and the such, which is good, but the chronically sick patient, that may be paying the first $2,500 to $3,500, well that’s a big pill, and they don’t come in as frequently.”

MACRA Timeline

What To Do Now?

Is there a safe harbor to weather the coming storm?

Think of PPD as an inoculation for the MACRA virus.

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