How can virtual groups be beneficial?

With the goal of virtual groups being “to clinically benefit patients and to encourage collaboration”, the concept of virtual groups is still being fully defined by CMS. Ideally, virtual groups would allow individual physicians and small practices the ability to connect and pool together their resources when it comes to quality reporting and improvement. This provision would benefit the independent clinicians attempting to operate with the difficulties of reimbursement reform without taking away their independence.

Elation Health believes that virtual groups can and should be a powerful tool to not only create administrative efficiencies for the providers who participate, but also to encourage collaboration that improves the quality of a patient’s health care.

So far, this is what CMS has said about virtual group reporting within the Quality Payment Program, “Flexibilities and Support for Small Practices” PDF:

“Under MIPS, clinicians will have the option to be assessed as a group
across all four MIPS performance categories. The law provides that solo and small
practices may join “virtual groups” and combine their MIPS reporting. CMS is seeking
public comment on how virtual groups should be constructed, and anticipate being able
to implement virtual groups in the second year of the program. CMS wants to make sure
the virtual group technology is meaningful and simple to use for physicians.”

Elation Health believes independent provider-led initiatives like virtual groups should be at the focus of CMS’ strategy for implementing MACRA.

Additionally, because we are so excited for the addition of virtual groups into the MACRA Final Rule, we have provided feedback on the concept of virtual groups to CMS. In our comment we detailed specific suggestions for how CMS should implement these groups, including the metrics which should be utilized to demonstrate the effectiveness of virtual groups and their impact on care quality and health outcomes.

To learn more about how Elation is supporting independent physicians, read the full text of our comment here.