“Medicare traditionally pays doctors a fee for service. You see a doctor who performs a procedure or service. The doctor bills Medicare and is paid a set fee. MACRA flips that to where the doctor or hospital’s payment is based on the success of the treatment. The intent of the law is good, but it’s not well thought out.
“As a consequence of not thinking this through, the law can have significant unintended consequences, such as:
- Mass exodus of doctors from Medicare resulting in worsening of the doctor shortage crisis.
- Create incentives for over prescribing of pharmaceutical medications.
- Worsening of the opiate crisis.
- Harming the poorer and minority patients with lower social-economic status.
- Affect access of care to sicker patients.
“The Rubik’s Cube complexity of the law presents barriers to the understanding of the consequences. As doctors we are distracted by the weeds of implementing the law.”
LTC Comment (from Stephen A. Moses, President, Center for Long-Term Care Reform):
Keep an eye on this MACRA legislation and its implementation. I analyzed it and pointed out its likely deleterious impact on long-term care in “LTC Bullet: The Future of Long-Term Care Seen Through the Prism of History,” Friday, November 13, 2015.
The next healthcare crisis: Changes in way Medicare pays doctors