The Association of American Physicians and Surgeons (AAPS) has issued a statement encouraging physicians to withdraw from Medicare in response to the Medicare Access and CHIP Reauthorization Act (MACRA) proposed rule.
The organization cites a recent Medscape Medical News survey that indicated 36 percent of physicians predict a mass exodus from Medicare by solo clinicians and small group practices due to MACRA’s current structure, which disproportionately penalizes those groups.
The group raises additional concerns about tying compliance scores to physicians’ use of resources and the mandated use of government-certified electronic health records, which the AAPS claims harm patient privacy and impede face-to-face patient care. In extending MACRA’s rules beyond Medicare, allowing all insurance-based healthcare to use similar payment models, the group sees further negative potential.
While other industry responses have been mixed, organizations have generally been requesting a variety of changes designed to simplify the rule and further delay its implementation, according to recent reporting by FiercePracticeManagement. For example, Bob Doherty of the American College of Physicians has urged physicians to keep the proposed changes in perspective. For its part, the American Medical Association has solicited constructive changes for the law’s improvement, reminding doctors that opportunities to shape the legislation remain available, and warning that a new administration or different Congress would be unlikely to give up on the rule completely.
But the AAPS said that ship has already sailed, at least when it comes to doctors in solo or small practices. “Physicians need to withdraw from Medicare or any other program that subjects them to this rule,” says Jane M. Orient, M.D., the group’s executive director. She asserts that the rule offers both ethical and practical impediments to medical practice, and suggests full compliance with the rule is “probably impossible” even if practices were to adopt a dedicated legal team.