The Obama administration needs to win back rural and small practice doctors if a push to revolutionize healthcare payments is to be successful, House lawmakers said.
The White House recently released its first proposed rule to change how Medicare pays doctors. Instead of the normal method of fee-for-service, the proposal would pay doctors based on the quality of care they provide.
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The rule was a result of bipartisan legislation passed last year to eliminate a formula that cut doctor payments under Medicare.
A top administration official said rural doctors must be reassured that they will not be put out of business under the new model.
“Physicians who are in small and solo practices can do just as well as physicians in larger size practices,” said Andy Slavitt, acting administrator of the Centers for Medicare and Medicaid Services.
Slavitt spoke during a subcommittee hearing of the House Ways and Means Committee.
Slavitt said the move to quality of care would require doctors to report data to determine the care provided to patients. For instance, hospitals would be measured based on the number of people who have to go back to the hospital after getting a procedure there.
House lawmakers wanted to ensure that rural doctors were not left behind, as doctors in larger practices have more resources to meet the quality measurements.
“Many physicians in solo and small practices have really struggled to stay afloat in recent years,” said Rep. Sam Johnson, R-Texas. “If CMS is trying to win back the hearts and minds of physicians, this proposal falls short.”
Slavitt downplayed concerns from Johnson that CMS data showed physicians in groups with nine or fewer doctors will do worse under the proposed payment model compared with larger groups.
“There is every opportunity and an equal opportunity for small practices to be successful,” he said.
Slavitt said the proposal hasn’t been finalized and CMS is holding a comment period on the rule.
“We are hoping people can give us even further ideas we can reduce the administrative reporting burden,” he said.
