For example, starting in 2019, if a practitioner receives $300,000 a year in Medicare reimbursements, a 4% loss is $12,000. “That cost might be absorbed,” Dr. Herzig says. “However, the penalty rises each year.
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“Doctors have to get moving now,” he adds. “There is no time to waste.”
In addition to knowing their budget, rheumatologists should look for ways to work together, Drs. Adams, Herzig, White and Kazi all say.
“We’re not going to survive as lone rangers, independently putting out every brush fire that comes along,” Dr. Adams says. “This movement toward quality and cost control in medicine is too big for any one doctor or small group of doctors to deal with. I think the ACR’s efforts are vitally important, and members really need to support and contribute to it in terms of leadership.”
In her statement, Dr. Von Feldt says the ACR will continue to review CMS’s latest proposed rule. The agency opened a window for feedback through June 27, 2016, and the ACR planned to submit detailed comments by that time.
Additionally, the ACR has created resources, including educational tools and a website specifically for MACRA, to prepare rheumatologists for the changing landscape.
“ACR members should learn about MACRA and learn what the ACR is doing to be proactive,” Dr. Adams says. “They should also consider participation in RISE.”
He adds, “In order to survive as rheumatologists, we are going to have to figure out how to swim in the great, big MACRA ocean without being eaten.”
Editor’s note: Since this article was written, the ACR has released its official comments and recommended changes to the MACRA proposed rule. The letter to CMS is available on the ACR website at www.rheumatology.org/MACRA.
- Von Feldt J. Rheumatology Community Responds to MACRA Proposed Rule. American College of Rheumatology. April 28, 2016. Accessed online May 30, 2016. Available at: http://www.rheumatology.org/About-Us/Newsroom/Press-Releases/ID/741/Rheumatology-Community-Responds-to-MACRA-Proposed-Rule#sthash.3oZMEiID.dpuf
- Clough JD and McClellan M. Implementing MACRA: Implications for Physicians and for Physician Leadership. Journal of the American Medical Association. 2016. E-pub head of print. doi:10.1001/jama.2016.7041. Accessed May 30, 2016.
Kelly April Tyrrell writes about health, science and health policy. She lives in Madison, Wisconsin, where she is usually running, riding her bike, rock climbing or cross-country skiing.