What are virtual groups and how can primary care physicians benefit from them?

In an effort to reduce the reporting burden on small and independent primary care practices participating in the Quality Payment Program (QPP) as required by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), the Centers for Medicare & Medicaid Services (CMS) has issued a proposed ruling that outlines a number of changes for 2018. One of the most significant aspects of the proposed change is a concept called “virtual groups.”

For primary care physicians, the new ruling should alleviate much of the administrative burden of complying with program requirements. With the new proposed rule, says CMS Administrator Seema Verma, the aim is to “improve Medicare by helping doctors and clinicians concentrate on caring for their patients rather than filling out paperwork.”

Virtual groups will be comprised of 10 or fewer eligible physicians, who join together virtually to participate in the Merit-based Incentive Payment System (MIPS) in 2018. Virtual groups ease the burdens on primary care physicians as they will be able to pool their resources and report together. Elation plans to offer functionality to these providers that allows them to dynamically collaborate on patient charts – a key driver of success in the new MACRA reimbursement system.

Elation believes that virtual groups can and should be a powerful tool to not only create administrative efficiencies for participating providers, but also to clinically benefit patients and to encourage collaboration that improves the quality of their health care. Independent physicians are already focused on the quality of care they provide to their patients and generally are adept at coordination of services. Virtual group participation should improve the quality of care received by patients of the participating providers by facilitating care coordination and improvement activities.

CMS states that “The Quality Payment Program, updated annually as part of MACRA, is meant to promote greater value within the healthcare system.” The new proposed ruling on virtual groups will enable primary care physicians to more actively participate in this program and to continue to contribute to higher quality healthcare delivery.