TMA PracticeEdge
have begun transitioning to value- based contracting, and in the coming years, “MACRA very quickly tran- scends from Medicare into the over- all market” by counting private payer models toward its APM criteria, said Dr. Lockhart, an American Medical Association delegate. He adds the post-SGR transition
TMA PracticeEdge is a new services com- pany TMA developed to bring physicians the technology and expertise they need to take advantage of new health care payment models. TMA Prac- ticeEdge provides Tex- as physicians with real options to design their future. Working with strategic partners, TMA PracticeEdge offers physicians a unique toolkit of account- able care organization services backed by the trusted TMA brand. For more informa- tion, visit
www.TMA
PracticeEdge.com, email info@TMA
PracticeEdge.com, or call (888) 900-0334.
“is not for the faint of heart, but the status quo is not going to be an option, regardless of any election or patient population. This is going to impact physicians’ entire patient load at some point, and it’s going to take an active and cooperative effort for physicians to look at what they are doing, and ask themselves: Is there a better or more cost-effective way to deliver good pa- tient care? If not yesterday, then today would be the next best alternative to get started.”
BETTER FOOTING Medicare already implemented the first phase of the new payment legis- lation, a 0.5-percent increase in physi- cian fees on July 1. Similar 0.5-percent annual increases will follow through
December 2019. In a July proposal to update 2016 Medicare payment poli- cies, the Centers for Medicare & Med- icaid Services (CMS) also announced that it would start taking comments on implementation of MIPS and APMs as part of “a broader effort … to move the Medicare program to a health care system focused on the de- livery of quality care and value.” Generally, TMA leaders agree MA-
CRA represents at least a marginal improvement over what physicians faced under the old SGR regime — not the least of which was an impending 21-percent pay cut in 2015 preceded by a decade of similar payment un- certainty — and under the Affordable Care Act and other legislation, which created a slew of administratively confounding and overlapping penalty- based quality programs. “From a political standpoint, it
means the TMA and AMA no longer have to spend our political capital to avert the cut,” eliminating a huge hurdle, says Donna Kinney, director of TMA’s Research and Data Analysis Department. The law also somewhat
POST-SGR TIMELINE Old law 2015
21% pay cut under Sustainable Growth Rate (SGR) formula
New law 2015–19
0.5% annual fee- for-service (FFS) payment update
2015–19 & beyond
4.5% to 11% maximum penalties under Physician Quality Reporting System (PQRS), meaningful use (MU) of electronic health records, and value- based payment modifier (VBM)
2017
Start of Merit-Based Incentive Payment System (MIPS) performance years
2018
PQRS, MU, VBM penalties sunset
58 TEXAS MEDICINE September 2015
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68