Government Healthcare Policy, Business and Technology

GAO Report to Congress: New Medicare Payment Models Prove Frustrating for Small Practices

Healthcare Informatics: A review of literature and Centers for Medicare & Medicaid Services (CMS) documents by the Government Accountability Office (GAO) has identified various challenges faced by small and rural physician practices when participating in Medicare's new payment models.

As the 39-page GAO report to Congress stated, in recent years, CMS has used its authority to develop and implement value-based payment models in which providers may receive additional payments for providing high-value care based on quality and cost metrics designed for each model or be financially penalized for care that does not meet certain standards. To this end, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) included a provision that GAO examine organizations that can assist small physician practices with participation in these models.

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