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CMS assures small-practice doctors they have a place in MACRA


– Fear over how Medicare officials will operationalize the Medicare Access and CHIP Reauthorization Act – known as MACRA – should not be driving physicians in small and solo practices to become employees of large systems, a top federal health official said.

“If people want to sell their practices and they want to [be a] part of integrated care models for other reasons, that’s fine,” Andy Slavitt, acting administrator of the Centers for Medicare & Medicaid Services said during an Oct. 6 event hosted by the Association of Health Care Journalists. “I think we have to make a really big effort though to make sure that they are not being driven there because the world’s getting too complicated ... and they throw up their hands.”

Andy Slavitt, acting administrator of the Centers for Medicare & Medicaid Services

Andy Slavitt

To that end, he chastised the consultant and hospital community for pushing the story that MACRA is going to be the death knell for the small or solo physician practice.

“There are people throwing fear. There are consultants and there are hospitals saying MACRA is going to be impossible,” Mr. Slavitt said. “They don’t know the support that’s going to be provided. It is in certain people’s interest to put the story forward that small physician practices are doomed.”

One aspect of that support has already been announced – that physicians will have flexibility in terms of how much, or how little, they want to participate in the reporting requirements if they are selecting the Merit-based Incentive Payment System in 2017.

While it will be a challenge, Mr. Slavitt said the final MACRA regulations – due out in early November – will support small and solo practices so that they can be successful in the program.

“Health care has become more and more of a business and it becomes harder and harder if you don’t have those kinds of operations. But there are other ways to do it and I think we are going to be successful in a lot of ways,” he said.

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