MIPS Math: a losing equation for physicians and patients

Dr. Jane L. Hughes reacts to the latest offer for MIPS “training”: http://conta.cc/2ps7YTq

I will bet that in their course they will not mention that “the physician must [participate in MIPS]” is not true. The physician chooses to comply in the hope of getting that 9% increase in Medicare payment. CMS says 47% of physicians will lose the zero sum game of MIPS. Weill Cornel Medical college estimates the cost of compliance with EMR, PQRS, etc to be $40,000/physician/year. As I’ve said before, do the math. You would have to clear $430,000 at a 9% return (if you are in the elite compliers) to reimburse yourself for your compliance costs. Hey, then you’d be rolling in reward money…What a thinly veiled process to gather the data to justify real time treatment dictates. I know of no other profession that would give up their privileged communication without a tooth and nail, knock down drag out fight, except the medical profession. If only because of the disastrous treatment implications of not being able to candidly talk and privately record medical and surgical encounters, it would seem to me that all physicians, in spite of the many compliance courses, should choose to just say no, at least to “interoperable EMR with 24/7 unfettered access” by HHS and CMS, as dictated in the MACRA law.

Best regards,

Jane

58 Hours of CME George Orwell Style

Friend of IP4PI Jane Hughes, MD writes in:

Anyone who thought that things were on hold regarding continued implementation of ACA and the statist move by Medicare via MACRA and its payment scheme called MIPS to centralize and control patient and physician choices needs to read this upcoming offering for unprecedented free CME from one of our premier institutions, Johns Hopkins. Key to centralization is electronic medical records that are interoperable. Read that to mean 24/7 access by government/insurance for data gathering and eventual treatment rubrics. Note that all of these CME hours are not featuring medical or surgical issues, they deal with “educating” and indoctrinating physicians on the advisability of population based care.

This is a sinister turn for the worse. We should have gotten a health plan through in some form to start the dismantling of ACA and trumpet the message that this is the beginning of decentralizing healthcare. Critical to reform of Medicare and getting rid of MACRA is a stable, affordable, and accessible private option.

These sponsoring organizations are proceeding as if nothing has changed. Until Trump appointees get rid of entrenched bureaucrats subversive to the true reform of statist ACA this is no surprise. The collusion with insurance and govt also needs to be exposed. These two forces are insatiable looters of tax monies, people’s premium moneys, individual human dignity, and doctor and physician choices. Note they are offering 58 hours of CME credit/brainwashing. What an impotent feeling to read that even an institution as grand as John Hopkins has succumbed to the George Orwell form of medical care.

Who does “Organized Medicine” work for?  Follow. The. Money.

With a significant portion of their physician constituency opposing the misnamed Affordable Care Act, i.e. Obamacare, and set to be harmed by bureaucracy-laden MACRA regulations why are some of the biggest names in “organized medicine” out in front cheering on these harmful programs?

Follow. The. Money.

The American College of Physicians has received about $3.5 Million in taxpayer funds from the federal government since 2011:
https://www.usaspending.gov/Pages/AdvancedSearch.aspx?sub=y&ST=C,G,L,O&FY=2016,2015,2014,2013,2012,2011&A=0&SS=USA&RN=American%20College%20of%20Physicians

The AMA $5.4 Million (not including CPT royalties):
https://www.usaspending.gov/Pages/AdvancedSearch.aspx?sub=y&ST=C,G,L,O&FY=2016,2015,2014,2012,2011&A=0&SS=USA&RN=american%20medical%20association

And this is “chump change,” explains Dr. Meg Edison, compared to the $86 Million taxpayer dollars the American Academy of Pediatrics raked in. “No wonder they were hashtagging the heck out of #VoteKids at election time. It’s a big business.”
https://www.usaspending.gov/Pages/AdvancedSearch.aspx?sub=y&ST=C,G,L,O&FY=2016,2015,2014,2013,2012,2011&A=0&SS=USA&RN=American%20academy%20of%20pediatrics

Bob Doherty, Exec. Dir. of ACP retorts that the taxpayer dollars “to help docs improve quality isn’t a COI but core to ‘ mission to promote excellence in medicine.”

“Helping docs improve quality” is apparently a euphemism for training physicians to comply with the crushing burdens of ACA and MACRA, a program passed in the name of “quality” but which ultimately punishes physicians for practicing individualized patient care, instead of cook book medicine as defined by CMS policy-wonks.

A sizable chunk of the funds flowing to ACP is ACA-driven funding “to help health providers achieve large-scale transformation” and “ensure sustainability” of these efforts.

With these large sums of money flowing into the coffers of those supposedly representing America’s physicians and their patients, it’s past time for hard questions to be asked and answered. Whose interests is “organized medicine” really looking out for? A hint: it’s not physicians or patients…

IP4PI to CMS: Exempt Independent physicians from ACA MACRA MIPS and APMs

CMS ACA MACRA MIPS and APMs discriminate against independent solo and small primary care practices, while unfairly advantaging hospital health systems who employ doctors. Please exempt solo and small physician practices of 9 or fewer doctors or less than 999 Medicare patients. CMS ACA MACRA MIPS and APMs will put small independent practices out of business and will deprive patients of their physician, jeopardizing their health.

Submit your comments at:

https://www.regulations.gov/comment?D=CMS-2016-0060-3944

Don’t Ignore the Lessons of History: MACRA will simply not work

The following MACRA comments were written by a Kansas City dermatologist, Viseslav Tonkovic-Capin, MD, who grew up under Communism in Czechoslovakia.

I was born and raised in communist Yugoslavia. My dad was a 9 year-old boy when WWII started and was courier for partisans, i.e. resistance against nazis and fascists during the war. After the war it was easy to dupe people into communism, because as an idea it sounded great, but within a several months or years almost everyone realized that it simply will not work.

My dad became lawyer and judge just to end up in the political prison because of his disagreements with the communist interference into his judicial duties. In short order my entire family turned from communists and communist sympathizers into people severely allergic to anything resembling communism.

My dad summarized the difference between communism and the Free World: Continue reading

Trump calls a congressman physician to lead real patient-centered reform at HHS

IP4PI joins patients and physicians across the United States in cheering the appointment of Congressman and orthopedic surgeon Tom Price, MD to head the Department of Health and Human Services in the incoming Trump administration.

Dr. Price has a long history of standing up for the patient-physician relationship against the myriad forces seeking to intervene to the detriment of quality patient care.  And indeed, proponents of top-down government control are quickly sounding the alarm  realizing they have an enemy in the congressman & good doctor from Georgia.

We look forward to supporting Dr. Price in his efforts to roll back ObamaCare, MACRA, MU and many other failed policies harmful to American medicine. Proven patient-centered solutions can then be unleashed to increase access to high-quality, low-cost medical care.

Congratulation’s Dr. Price on this well-deserved new job!  We are here to help you in this crucial and challenging work over the coming years.  The future of American patients and physicians will depend on it.

MACRA = The Destruction of Medicare and Those Practices That Attempt to Comply

Greetings,

Here are my thoughts on reading my section of the “final” rules. If anything is apparent it is that there is no such thing as final rules, and in fact everything in the section I read was prefaced with disclaimers. I would like to entitle my section as, “The Destruction of Medicare and Those Practices That Attempt to Comply.”

This publication of the finals rules is almost of zero value to any physician or any patient, and in fact is a gobbly-gook of acronyms that hardly make sense and make the reading of the rules almost impossible without constant reference to their senseless definitions. There is nothing remotely suggestive of the actual practice of medicine. For example, CMS regards radiologists and pathologists as “non-patient facing MIPS eligible physicians.” One is struck with every rule and condition with the obvious question-how many bureaucrats at what expense would be required to track, collate, evaluate, and determine payment on over 800,000 physicians with this unwieldy payment system disguised as “quality not quantity” rewards. Continue reading