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May 05, 2016

Medicare's proposed new compensation plan will work against small medical groups and solo clinicians, according to the Medical Group Management Association.

The default mode of the compensation plan, proposed April 27 by the Centers for Medicare & Medicaid Services, is the Merit-Based Incentive Payment System, or MIPS, and will initially cover the vast majority of physicians. MIPS is structured to award performance bonuses as high as 4% to an estimated 412,000 physicians and other clinicians in 2019. Another 346,000 clinicians, mostly in practices with fewer than 24 members, are likely to be penalized by as much as 4%, partly because they don’t have the support staff to shuffle through MIPS guidelines and data entry, or help achieve patient outcomes on which their performance will be rated.

"It's extremely concerning," Anders Gilberg, senior vice president of government affairs for the MGMA, told Medscape Medical News. "Any program like this should give physicians the opportunity to succeed regardless of practice size."

The proposed CMS policies create a seemingly uneven playing field in which 87% of solo clinicians get penalized and 81% of clinicians in large groups earn bonuses, Gilberg added. MGMA will attempt to determine how the proposed policies led to these skewed results.


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