More than two-thirds of small physician practices foresee the loss of their independence by closing their doors or selling to larger groups due to the requirements of the Merit-Based Incentive Payment System (MIPS) and related technology issues, according to a new survey from Black Book Rankings.
The survey, of 1,300 physician groups of five or fewer clinicians, found that many did not have the technology, capital or staffing for MIPS and value-based care. Sixty-seven percent of doctors with a high Medicare patient population believed that they would not be able to maintain their independence. Almost nine in 10 (89 percent) of the remaining solo practices expect to minimize their Medicare volume in order to avoid having to submit quality and clinical practice improvement activities or reporting in the cost performance category.
Most physicians participating in the Meaningful Use program will be transitioned to MIPS, which was created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). MACRA replaced the much-criticized Sustainable Growth Rate formula under which physicians had been paid.
Seventy-seven percent of small practices identified as financially struggling due to physician staffing losses to large groups and hospitals. Seventy-eight percent of the remaining independent primary care physicians plan to join bigger groups or hospitals to gain support to obtain needed reporting, revenue cycle tools and support before 2019.
Black Book expects the EHR market for larger practices and hospitals to increase as a result of the acquisitions of these smaller groups. However, the EHR replacement market for small practices will decline, as 55 percent of respondents expect no technology shifts or purchases until they’ve made decisions about being acquired.
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