The trend of physicians choosing to be employed by large hospitals or health systems rather than continue in independent practice may accelerate under the new payment tracks of the Medicare Access and CHIP Reauthorization Act (MACRA), according to Lawrence Casalino, MD, PhD, a professor at Weill Cornell Medical College.
In an article in the May 2017 issue of Health Affairs, Casalino wrote that MACRA encourages smaller practices to organize under Advanced Alternative Payment Models (APMs), like the Comprehensive Primary Care Plus (CPC+) model, offering technical assistance and requiring less financial risk. In his opinion, however, the hurdles will still be too great, with even smaller-practice-friendly models needing investment and time which those providers can’t spare.
“Faced with MACRA’s complexity and the financial risk it introduces, many physicians are likely to throw up their hands, say “this is the last straw—I can’t take it anymore,” and seek shelter from the storm in large corporations,” Casalino wrote.
It’s not the first time Casalino has written about the burden of quality reporting. Adding to the confusion this time around, he said, is the new administration at HHS, which could change what APMs qualify under MACRA to be more “physician-friendly.”
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John joined TriMed in 2016, focusing on healthcare policy and regulation. After graduating from Columbia College Chicago, he worked at FM News Chicago and Rivet News Radio, and worked on the state government and politics beat for the Illinois Radio Network. Outside of work, you may find him adding to his never-ending graphic novel collection.