I've been reading the latest update on the Medicare payment system in Medical Economics. Boehner and Pelosi worked closely on getting a reform model that could establish a legislative edifice before they retire. The new bill killed the SGR, but put in place an increase of 0.5% for the next five years. (This will not even keep up with inflation.) The new Merit based Incentive Payment System (MIPS) will roll togetehr PQRS, MU, and value based modifier programs. Non-reporting physicians will receive a 4% penalty in 2019 and up to a 9% penalty after 2022. These penalties will go to pay "top performers" (top 25%) from 4 to 9% increase. I calculate at an average of 3% inflation since 1990, reimbursements will already be down almost 20% at that time from the present. For non-reporters, it will amount to a 24% to 29% effective cut, or an 11% to 16% cut if you are a top performer. Note that their incentives do not account for inflation. Those of us still taking Medicare payments have 5 years to consider another model.
