Dr Kate Goodrich Explains CMS Proposals for Small Practitioners

CMS has taken steps to make clinical practice improvement regulations easier for independent practitioners to understand and achieve, said Kate Goodrich, MD, director of the Quality Measurement and Value-Based Incentives Group in CMS.

Transcript (slightly modified)

How have physicians reacted to the new alphabet soup of MIPS, APMs, MACRA, and more? And what is being done to educate them?

So I think we’ve been doing a lot of listening to physicians and other types of clinicians since the regulation was published, before as well. And I think right now at this stage people are still absorbing, they’re digesting the regulation, they’re trying to understand it. I’ve talked to a lot of specialty societies who have developed what they call Reader’s Digest versions of our proposed regulations so that your average front-line clinician can understand what it is we’re proposing. So that’s the main thing right now, is that people are really just trying to understand it.

The one thing that has come out, that people are concerned about naturally, is how this impacts the individual solo practitioner as well as clinicians that are in small group practices. And you know, these are very dedicated, hardworking clinicians who want to provide the highest quality care to their patients and undoubtedly they are doing that. But the work that has to happen to be able to report on that work and the quality of care they provide is not a small thing. It is not trivial. So we worry about that too. We worry about those practitioners too.

I think as people sort of delve into the regulation a little bit more, what I hope they’ll see is that many of our proposals were really designed with that small practitioner in mind. In order to really reduce the burden from the current programs of what they have to do to report, for example, quality measures to us or to report measures about how they’re using their electronic health record to improve quality of care. So we really, in all of our proposals, we really were keeping the small and solo practitioner in mind.

Having said that, again, going back to the fact that there is help out there, we know that those doctors and lots of others as well are going to need help in understanding exactly what it is that they need to do. There are also a couple of provisions within the regulation that are targeted specifically at small group practices and individual clinicians.

As one example, under the clinical practice improvement activities, the number of activities that clinicians in rural areas or in small practices or in health professional shortage areas, the number of clinical practice improvement activities they have to submit is lower than other practitioners. Because we understand that improving your care, taking action to improve care for patients, starting new programs, hiring other members of the team, takes resources that sometimes those practitioners may not have as much access to. So we really try to think about, what can we do within this regulation to reduce the burden yet still provide some flexibility for those practitioners.