How MACRA Will Decimate the Private Practice Physician

Niran S. Al-Agba, MD | | July 20, 2016

Small, independent private practices are closing, increasing numbers of physicians are retiring, and fewer medical school graduates are choosing primary care.  The old-fashioned practice my father and I have built is a dying entity.  Parents say coming to see us for an appointment feels more like a visit with a friend than a medical encounter.  I am fighting for the survival of primary care practices.  MACRA proposed reimbursement will decimate rural care as we know it.

Recently, I attended an “informational listening session” for rural physicians, sponsored by the Center for Medicare and Medicaid Services (CMS) to learn more about the new MACRA proposal known as MIPS/APM (Merit-Based Incentive Payment System/Alternative Payment Model.)  This plan will penalize 7 out of 10 small 1 to 2 physician practices in this country.  Why? Because we will be overwhelmed complying with statistical reporting demands that do nothing to enhance the quality of care, instead of spending precious time seeing patients. I inquired as to how CMS proposes to ease our burden of data reporting. “I am not sure, but leave a website comment and someone might consider your needs.” Not likely.  

A family practice physician described how technical mistakes at the claims clearinghouse froze her Medicare payments for eight months. “Thank God my father died and left me a small inheritance,” she said. Otherwise, her solo practice would have gone bankrupt.  Is this the future of medical care in this country?  Over 50 percent of her patients are on Medicare.  If we allow this MACRA atrocity to go into effect, who will be left to care for the sick, disabled, and elderly?...