Dr. Victor Roberts
Although Dr. Roberts’ practice focuses on endocrinology, diabetes, and metabolism, many of the ICD treatment codes it uses qualify it to participate in PCIP. “We have not seen a dramatic increase in revenue for ambulatory office-based work,” he said.
How the program affects physicians could also be a function of the size of the practice and whether the physician is employed by a system, he added.
Dr. Charles Crecelius, geriatrician at Barnes Jewish Medical Group of St. Louis
I have “just changed from a private practice small physician group to a larger hospital-based group practice, so my perspective is changing somewhat. In our smaller private practice, [the end of the incentive payments] was going to be a serious blow to our fiscal stability as we see predominantly older patients and depended on the income to support our ability to modernize our practice. Under value-based medicine, we might be able to make up some of the difference by performing well, but our ability to make up all the income is very doubtful. We were seriously contemplating curtailing new Medicare patients and increasing our younger population practice.
Dr. Charles Crecelius
“Now that we have just joined a larger group, we will be insulated from any immediate impact of this additional income as our payment structure has no bearing on this additional source of revenue. The decreased total revenue to the larger group practice will be substantially diluted by the total much larger non-affected incomes – surgery, younger patients, ancillary income, etc. The payment structure to the individual physician never did take into account this additional payment – and in fact in the past this was a source of contention to some of the members of this larger group who saw a lot of Medicare patients, I am told. Curiously now it will not impact them.
“This loss of additional income will have a greater impact on the smaller groups and solo practices, and will be one more nail in the coffin of traditional small primary care practices. While not a major influence in our decision to join a larger practice – EHRs, meeting quality metrics, controlling costs were bigger more longstanding issues – it did play a role.”
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