To understand how Medicare will pay them in the coming years, physicians have to digest new regulations that lay out the details of metrics they'll have to report on and data they'll have to analyze. Doctors' responses will affect their income starting two years from now.
Or they can pay someone else to sort it out.
A rush of companies are selling services they say will help providers succeed under Medicare's new physician payment framework and other programs in an ever-expanding stable of payment reform initiatives.
“Value is the new economy, and measurement is going to be the new currency,” said Craig McKasson, chief financial officer of Premier, a Charlotte, N.C.-based company that's aggressively growing its division dedicated to healthcare performance-improvement technology and services.
On Oct. 14, the CMS issued its final rule implementing the Medicare Access and CHIP Reauthorization Act, or MACRA, which made significant changes to the draft rule. The law was conceived to coax the entire industry toward value-based care, and it's accelerating the demand for third-party experts whose services encompass everything from simply capturing information to analyzing it for performance improvement.
Some of these companies are relatively new. They were born as the 2010 Affordable Care Act produced a spray of new models experimenting with ways to tie healthcare reimbursement to quality and efficiency. Others have been in the performance services segment for years but are enjoying a boom in business, thanks to the expansion of value-based payment schemes that depend heavily on the complex and often burdensome gathering, submission and analysis of data in order to assess quality and costs of care.
Premier's performance services segment saw revenue growth of 19% in the fourth quarter of fiscal 2016 compared with the previous year. The company said it expected sales to increase in the performance services segment in fiscal 2017.