Welcome to Reform in 5 Minutes!

Welcome to the first in a series of brief educational bits about our future in clinical practice. Why should you read this? Because our simple fee-for-service methodology of payment in healthcare WILL LIKELY BE PHASED OUT. If you think this payment reform will be quashed in 2016, it is unlikely. This is because the government knows that we need to address the runaway healthcare budget. Reforming payment methodologies is the only way to do so. Private payers are on board as well. So, we all have 3 options: plan for the future, ignore it and accept the financial penalties, or exit clinical practice. The primer is intended to give you enough information to make that decision for your practice. To make it as easy on you as possible, we will break it up into bite size pieces that require 3-5 minutes of reading/contemplating at a time.

Let’s begin with the big picture, visually depicted below. The Medicare Access and CHIP Reauthorization Act of 2015 is a Medicare payment reform law. Medicare payments will move from traditional fee-for-service to value-based payment and population-based payment by 2019. Although all 4 payment methodologies will survive, only 10% of your payments will be traditional fee-for-service as it has been up until now. We will derive 90% of reimbursement for the practice of medicine from the 3 new methodologies, all linked to performance (“value”) . Next time, we will dive into penalties (we will come back to these payment methodologies). How you are performing THIS YEAR defines how much you will be paid in 2017!!

The Path that we are on……..reform path we are on