How the federal government helps make healthcare unaffordable/ Medscape

One big contributor to ridiculously high administrative costs of medicine in the US is the federal government.


Constantly changing federal rules seem to aim for complexity.  Compliance is nearly impossible for small medical practices, because Medicare changes its rules every few months. Doctors have to play by its rules, but it is very difficult to keep up with them.  Medicare feels no need to issue its rules on time, even after it announces their schedule for release.


Here is an example from today’s Medscape.  Just remember that YOU are paying for this nonsense, and it is one reason that healthcare has basically become unaffordable in the US:

“The Centers for Medicare & Medicaid Services (CMS) has announced that by the end of May, it will notify all clinicians who are eligible for payment under the new Merit-Based Incentive Payment System (MIPS). One of two payment tracks in CMS’ Quality Payment Program, MIPS was launched January 1. Physicians who are subject to MIPS will have their performance on quality, electronic health record (EHR) use, and practice improvement measured this year to determine positive or negative payment adjustments in 2019.

Physicians and other clinicians are subject to MIPS if they bill more than $30,000 a year in Medicare Part B allowed charges a year and provide care for more than 100 Part B–enrolled Medicare beneficiaries annually. They are exempt from MIPS, however, if they receive a specified percentage of income from one of several care delivery models that are known as advanced alternative payment models.

CMS originally said it would notify clinicians who must participate in MIPS by last December, before the 2017 performance measurement period began. But CMS failed to do that, leaving many physicians and group practices in limbo… 

CMS recently released a list of “qualified registries” clinicians can use to report their quality data, he said. But the agency has not issued a list of approved “qualified clinical data registries.” The qualified registries are mainly offered by EHR vendors, which can charge hefty fees for the service. In contrast, the more reasonably priced qualified clinical data registries are operated by specialty societies and quality improvement collaboratives.

Gilberg views this omission as a challenge for some practices that want to report more data to CMS this year to qualify for a bonus in 2019… 

CMS’ requirement that all MIPS participants use 2015 Edition EHRs presents practices with another quandary. So far, only two major EHR vendors, Epic and Allscripts, have had their 2015 Edition EHRs certified by the government. There is serious concern in the industry that the bulk of eligible clinicians will not have 2015 EHRs by the start of the 2018 reporting period….

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