MACRA's Influence on Physician Reputation Management and What It Means for Patients

Most people in healthcare would agree that there is no correlation between a physicians’ MIPS Quality Score under MACRA and the quality of the physician. While MACRA and EHRs can improve patient care, there are a lot of reasons why your MIPS score should not be used as a measure of physician quality.

First, a lot of doctors have chosen to opt out of participating in MIPS altogether and will, therefore, have a MIPS quality score of 0. Does this mean they are poor quality providers? Definitely not! The same is true for providers who choose to do the simple MIPS “test pace” and score a 3 out of 100 for their MIPS quality score to just avoid the penalties. Does the fact that they basically chose not to participate in a government program mean that they’re not a great provider? Definitely not! They might be a great provider or an awful provider, but the MIPS quality score isn’t any indication of where they lie on that spectrum. (To find out more about your MIPS participation options for 2017, check out the webinar: Are You On Track for MIPS Success?

The problem with this is that most patients won’t be diving into these details to know what the MIPS Quality Score really means. Instead, they will likely just see the word “quality” and assume that the MIPS score is an indication of the quality of the provider. That’s a scary thought to consider if you’re a provider who is choosing to not really participate in the MIPS program and will therefore be listed with a very low score.

Many of you might be wondering how a patient is going to ever find out a physician’s MIPS quality score. Certainly no patients are going to go to the CMS website in search of MIPS quality scores, but they won’t have to. CMS will publish all of this data in a simple to access API which will then be published on the top physician ratings websites like Health Grades, ZocDoc, Yelp, Physician Compare, Angie’s List, etc. 

Don’t think this will happen? It already happened once when CMS released Medicare and Medicaid procedure data which was then published to many of these physician ratings websites. The same is likely to happen with your MIPS quality score. Patients are increasingly using these ratings websites to evaluate and select their provider and don’t expect these ratings websites to clarify what the MIPS quality score really means. A low “quality” rating will likely scare many patients away from your practice.

For this reason, providers should include their participation in MIPS and MACRA as part of their reputation management plans. Not doing so could have a real impact on their practice’s ability to recruit new patients to their practice. Plus, it could make it a challenge for providers wanting to change practices since the MIPS quality score will stay attached to the provider and not the practice.

As for patients, the MIPS quality score could have a big impact on them. It’s not hard to imagine the disappointment a patient will have when they find out that their provider has a high MIPS quality score because they are good at jumping through government regulatory hoops and not because they provide high quality care. The term “buyer beware” certainly applies, but that is usually little relief when it comes to healthcare.

To learn more about having a patient-centered perspective for modern medical practice management, join me in my upcoming webinar:

Understanding Patients: The Secret to A Thriving 21st Century Medical Practice (webinar)

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About the Author

John Lynn is the Editor and Founder of the nationally renowned blog, the leading healthcare IT job, and the...

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