ObamaCare's effects upon Physician's practices

“Due to years of mounting regulations, the solo practice in which patients stayed with the same physician for 20 to 30 years is most likely a thing of the past. That, in and of itself, is interference with the practice of medicine.

The Galen Institute: PRIVATE PHYSICIAN PRACTICE TAKES ANOTHER BLOW FROM A NEW 2,400-PAGE GOVERNMENT RULE   "Just before former House Speaker John Boehner handed the gavel to Paul Ryan, he shepherded legislation that eliminated a despised Medicare payment formula under which physicians faced a 21.2% pay reduction.

"Congress could not allow the pay cut to take place and take the risk that physicians would turn away their Medicare patients. But the “Sustainable Growth Rate” payment policy for Medicare was law—passed as part of the Balanced Budget Act in 1997 to restrain government spending.

"Physician groups swarmed Capitol Hill every year for more than a decade to oppose significant cuts, and the physician payment reductions had been averted 17 times by congressional patchwork.

"Finally, last year, the SGR was eliminated with MACRA—the Medicare Access & CHIP Reauthorization Act that passed Congress with bipartisan support and was signed into law by President Obama.  It called for physicians to receive a 0.5% payment update (instead of a 21.2% pay cut), but the price was creation of a new payment program to reward quality performance.

"The Centers for Medicare and Medicaid Services (CMS) was tasked with writing the implementing rules for how MACRA would work.  Its proposed rule spelled out the details of how Washington would pay for “value” not “volume” under the fee-for-service payment system.  Physicians and other clinicians would now be financially rewarded or penalized based upon how well they satisfy a complex new system of government rules meant to improve quality of patient care and control costs." . . .

Grace-Marie Turner is president of the Galen Institute, a public policy research organization that she founded in 1995 to promote an informed debate over free-market ideas for health reform.