The US Government Accountability Office Turns its Attention to Small Independent Practices January 12, 2017
The shift from fee-for-service to value-based reimbursement encourages physicians to adopt electronic health records and better track and assess the quality of patient care.
“But are small and rural physician practices prepared for such as transition?” asks the US Government Accountability Office (GAO), which was tasked by Congress to report on how different groups can support small and rural practices during the transition to value-based care.
The GAO report discusses the challenges small practices face in five areas, including health information technology (IT) and quality and efficiency performance measurement and reporting. The resulting report is based on existing literature and interviews with 38 diverse stakeholders, including independent physicians.
Uncovering Challenges for Small Practices
According to the GAO, one of the biggest roadblocks for the practices studied was a lack of financial resources. For many small practices, the constrained ability to make extensive investments and accrue financial risk creates the need for a cost-effective solution to support the practice transformation demanded by value-based programs.
These practices are in need of significant resources like access to data for care management and cost containment. This data is not readily available to physicians without expensive business analytics tools. Additionally, a lack of personnel can have an adverse impact on existing personnel at small practices, as the scope of administrative and compliance responsibilities increase.
Another key issue called out in the report links the delay between data submission and feedback from CMS on performance as a major challenge for small practices. This “time lag” makes it difficult for insights to become actionable and help practices drive their own process improvements. It can also be detrimental toward investments made for program participation, as practices attempt to recoup these expenses through bonus payments that arrive years after initial investments.
Small and Rural Practice Allies
Though the GAO’s findings may feel alarming for independent physicians, the GAO also noted the importance of outside groups and organizations in playing a role to help small practices overcome these obstacles. The GAO report pointed to both direct and indirect partners, including health IT vendors as crucial to small and rural practice success.
At Elation, we believe that independent physicians shouldn’t have to worry about the shift to value-based care and should instead focus on caring for their patients, while “helping hands” step in to support their roles as caregivers. Here at Elation, we’re more than willing to help small and rural practices succeed, whether that means improving our product, providing specific guidance on policy issues, or even advocating on behalf of the independent physician community.
This is also why Elation specifically supports the government’s intention, under the Medicare reform passed last year called MACRA, to allow small practices to join together in virtual groups. These groups can provide a common platform for reporting, data driven insight, and process improvements that can address some of the challenges called out above.
Independent practices are uniquely situated to deliver on the promises of value-based care because of their patient-centered approach. With a track record of providing this kind of top-notch care, we’re excited to continue to champion the the role of independent physicians during the transition to value-based care.