Physician Well-Being: Financial Aspects

The US health care system has an unequal distribution of physician supply, is poorly accessible in some areas, and has wide disparities in patient health status. The Patient Protection and Affordable Care Act (ACA) was intended to address these issues by providing affordable health insurance coverage, Medicaid expansion, and care delivery system redesign (particularly through physician payment reform). As part of payment reform, the Medicare Access and CHIP Reauthorization Act (MACRA) went into effect in January 2017. Under MACRA, physicians receive payment under the Quality Payment Program (QPP). Starting January 1, 2019, the QPP pays physicians Medicare part B payments based on their 2017 performance via one of two ways: an advanced alternative payment model or the Merit-Based Incentive Payment System (MIPS). Most physicians will be placed in the MIPS. This shift to performance-based payment requires practices to optimize financial aspects of practice management and improve critical workflows and care delivery processes.