Docs hesitant on ACOs, new payment models with looming Medicare cuts

Physicians would be more willing to explore new payment and delivery models if Medicare payments were more stable, MGMA-ACMPE announced yesterday.

According to a MGMA-ACMPE survey of more than 26,000 doctors at 1,000 physician group practices, only 18 percent said they are already participating in a new Medicare payment model. Those who are not experimenting with alternatives to fee for service cited unpredictable Medicare payments, notably the 27 percent cut slated to go into effect Jan. 1, 2013.

If Medicare was to stabilize the payment system, 82 percent of physician respondents would be more likely to explore new models. Specifically, if payments were stable for five years, the majority of practices would consider alternative models such as the Medicare Shared Savings Program, bundled payments or comprehensive primary care initiatives, MGMA-ACMPE noted.

The survey echoes MGMA's call, urging Congress last week to repeal the sustainable growth rate (SGR) formula. Called a "decade of temporary, last-minute congressional reprieves," the short-term fixes have made Medicare payment unpredictable and have had an impact on their practices, providers said.

Forty-five percent of surveyed physicians said they would cut back on appointments for new Medicare patients if Congress does not prevent SGR cuts; a third (31 percent) said they will stop accepting new Medicare patients. The planned SGR reduction also means physician practices might reduce staff salary or benefits (76 percent), cut administrative support (65 percent) or reduce the number clinical staff (58 percent), they said.

"Our research shows that physician practices are willing to engage in new Medicare payment and delivery models that reward high-quality, cost-effective patient care outside of fee-for-service," MGMA-ACMPE President and CEO Susan Turney said in a statement yesterday. "Now Congress must do its part, repeal the SGR, and provide stability in Medicare payments so physicians can explore and test new patient centered approaches."

For more information
- see the MGMA study results (.pdf) and announcement

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