The single life may prove troublesome for specialty group practices under MACRA.
David Fitzgerald, CEO of Proliance Surgeons in suburban Seattle, said specialty practices are in the dark about their fate under the new physician reimbursement system.
Things are clearer for primary-care practices in determining costs and quality involving care for Medicare patients, he said. But specialty practices like his, which has 420 providers and generates $400 million annually in revenue, will have to wait until the CMS releases its final regulations in November.
The uncertainty could forge greater alliances between the two worlds.
Proliance, where 25% of its patients and 17% of its revenue come from Medicare, has had some experience with Medicare's Bundled Payments for Care Improvement initiative, which required the group to put some revenue at risk. Starting about a year ago, Proliance opted in for diagnostic-related groups for orthopedic surgery and ignored those for general surgery, where it has small volume.