We hear much about the emphasis on improving quality care and even more about how to report and assess it.  Performance is being much more closely scrutinized.  The idea was to employ the huge benefits expected from electronic health records (EHRs), but that created more problems thus far than it solved.  Thus, the assessment still depends on direct reporting and claims data.

At the same time, the measures and rules initiated have proliferated to the extent there are over 1000 of them.  The result has been abysmal, resulting in mostly chaos.  Of course, doctors and their staffs spend inordinate amounts of time trying to figure out how to comply with all of the measures, with projections as high as 15 hours a week per physician.  Project the cost over a year and it is substantial.  It’s no wonder that the results of all the new applications, the confusion, and the cost have bothered providers to the extent that burnout is a common complaint.

Not to mention the alternative payment for Accountable Care (ACO) issues and MACRA (Merit-based Incentive Payment system), (AKA as MIPS).    Even though the physician groups that helped design the system disagree with many of the details – like how much risk does the plan pose for that incentivized payment process, and how will performance be graded, etc.  Projections show that the larger group practices will likely benefit but the smaller and solo practices will not, thus the expectation is that small practices will pretty much disappear.

Stay tuned.