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David O. Barbe, MD, is urging physicians to participate in the Medicare Quality Payment Program, even if the business case isn’t quite there.

QPP is the value-based payment system created by the Medicare Access and CHIP Reauthorization Act (MACRA). It promotes high-value care through Medicare payment increases. But for some practices, the investment in personnel and technology needed to earn those increases may be more than the increases themselves, leading doctors to do just enough to avoid being penalized.

“I think that many physicians don’t feel they are ever going to get a bonus but sure would like to avoid a penalty,” Dr. Barbe, president of the American Medical Association, said in an exclusive interview. “I am afraid many will simply perform at the lowest level that keeps them out of the penalty. Because many of them find that making the investment it takes to perform highly, there is not a business case for that.”

Full participation in QPP’s Merit-based Incentive Payment System (MIPS) could run small practices an additional $10,000 to $30,000 a year, he said. “If you’ve got $200,000 in Medicare receipts, if you get adjusted even the maximum of 4%, that is $8,000. You can’t cover $20,000 with $8,000. The math doesn’t work. There is not a business case there for it.”

That said, Dr. Barbe still spoke in favor of QPP and noted that the AMA is working with the Centers for Medicare & Medicaid Services as well as Congress to make the program more valuable and meaningful for physicians.

“We understand where we need to go as a profession, as an industry,” he said. “How we get there is the key, it’s the challenge and it requires flexibility. ... CMS has been accommodating but there are limits to how long they can go.”

The AMA is urging doctors who have missed the 90-day window for full participation – which effectively closed for most on Oct. 2 – to consider the Pick Your Pace option offered by the CMS.

gtwachtman@frontlinemedcom.com

David O. Barbe, MD, is urging physicians to participate in the Medicare Quality Payment Program, even if the business case isn’t quite there.

QPP is the value-based payment system created by the Medicare Access and CHIP Reauthorization Act (MACRA). It promotes high-value care through Medicare payment increases. But for some practices, the investment in personnel and technology needed to earn those increases may be more than the increases themselves, leading doctors to do just enough to avoid being penalized.

“I think that many physicians don’t feel they are ever going to get a bonus but sure would like to avoid a penalty,” Dr. Barbe, president of the American Medical Association, said in an exclusive interview. “I am afraid many will simply perform at the lowest level that keeps them out of the penalty. Because many of them find that making the investment it takes to perform highly, there is not a business case for that.”

Full participation in QPP’s Merit-based Incentive Payment System (MIPS) could run small practices an additional $10,000 to $30,000 a year, he said. “If you’ve got $200,000 in Medicare receipts, if you get adjusted even the maximum of 4%, that is $8,000. You can’t cover $20,000 with $8,000. The math doesn’t work. There is not a business case there for it.”

That said, Dr. Barbe still spoke in favor of QPP and noted that the AMA is working with the Centers for Medicare & Medicaid Services as well as Congress to make the program more valuable and meaningful for physicians.

“We understand where we need to go as a profession, as an industry,” he said. “How we get there is the key, it’s the challenge and it requires flexibility. ... CMS has been accommodating but there are limits to how long they can go.”

The AMA is urging doctors who have missed the 90-day window for full participation – which effectively closed for most on Oct. 2 – to consider the Pick Your Pace option offered by the CMS.

gtwachtman@frontlinemedcom.com

David O. Barbe, MD, is urging physicians to participate in the Medicare Quality Payment Program, even if the business case isn’t quite there.

QPP is the value-based payment system created by the Medicare Access and CHIP Reauthorization Act (MACRA). It promotes high-value care through Medicare payment increases. But for some practices, the investment in personnel and technology needed to earn those increases may be more than the increases themselves, leading doctors to do just enough to avoid being penalized.

“I think that many physicians don’t feel they are ever going to get a bonus but sure would like to avoid a penalty,” Dr. Barbe, president of the American Medical Association, said in an exclusive interview. “I am afraid many will simply perform at the lowest level that keeps them out of the penalty. Because many of them find that making the investment it takes to perform highly, there is not a business case for that.”

Full participation in QPP’s Merit-based Incentive Payment System (MIPS) could run small practices an additional $10,000 to $30,000 a year, he said. “If you’ve got $200,000 in Medicare receipts, if you get adjusted even the maximum of 4%, that is $8,000. You can’t cover $20,000 with $8,000. The math doesn’t work. There is not a business case there for it.”

That said, Dr. Barbe still spoke in favor of QPP and noted that the AMA is working with the Centers for Medicare & Medicaid Services as well as Congress to make the program more valuable and meaningful for physicians.

“We understand where we need to go as a profession, as an industry,” he said. “How we get there is the key, it’s the challenge and it requires flexibility. ... CMS has been accommodating but there are limits to how long they can go.”

The AMA is urging doctors who have missed the 90-day window for full participation – which effectively closed for most on Oct. 2 – to consider the Pick Your Pace option offered by the CMS.

gtwachtman@frontlinemedcom.com

Suicide prevention requires a multifaceted, comprehensive clinical effort, coupled with an equally comprehensive community effort.

“The clinician isn’t in it alone – none of us can do this alone,” explained Eileen Zeller, lead public health advisor with the suicide prevention branch of the Substance Abuse and Mental Health Services Administration.

In an interview at an event sponsored by Education Development Center and the National Action Alliance for Suicide Prevention, Ms. Zeller discussed new initiatives to get suicide prevention resources to clinicians and communities .

Suicide prevention requires a multifaceted, comprehensive clinical effort, coupled with an equally comprehensive community effort.

“The clinician isn’t in it alone – none of us can do this alone,” explained Eileen Zeller, lead public health advisor with the suicide prevention branch of the Substance Abuse and Mental Health Services Administration.

In an interview at an event sponsored by Education Development Center and the National Action Alliance for Suicide Prevention, Ms. Zeller discussed new initiatives to get suicide prevention resources to clinicians and communities .

Suicide prevention requires a multifaceted, comprehensive clinical effort, coupled with an equally comprehensive community effort.

“The clinician isn’t in it alone – none of us can do this alone,” explained Eileen Zeller, lead public health advisor with the suicide prevention branch of the Substance Abuse and Mental Health Services Administration.

In an interview at an event sponsored by Education Development Center and the National Action Alliance for Suicide Prevention, Ms. Zeller discussed new initiatives to get suicide prevention resources to clinicians and communities .

Reaching people at risk of opioid abuse and suicide will require a shift beyond a focus on treating individuals to a more comprehensive public health approach.

“The majority of people aren’t showing up at our treatment doors, so we have to have a very different approach if we’re going to reach everyone,” explained Arthur C. Evans Jr. PhD, chief executive officer of the American Psychological Association.

In an interview at an event sponsored by the Education Development Center and the National Action Alliance for Suicide Prevention, Dr. Evans discussed effective strategies for taking a population-health treatment perspective.

Reaching people at risk of opioid abuse and suicide will require a shift beyond a focus on treating individuals to a more comprehensive public health approach.

“The majority of people aren’t showing up at our treatment doors, so we have to have a very different approach if we’re going to reach everyone,” explained Arthur C. Evans Jr. PhD, chief executive officer of the American Psychological Association.

In an interview at an event sponsored by the Education Development Center and the National Action Alliance for Suicide Prevention, Dr. Evans discussed effective strategies for taking a population-health treatment perspective.

Reaching people at risk of opioid abuse and suicide will require a shift beyond a focus on treating individuals to a more comprehensive public health approach.

“The majority of people aren’t showing up at our treatment doors, so we have to have a very different approach if we’re going to reach everyone,” explained Arthur C. Evans Jr. PhD, chief executive officer of the American Psychological Association.

In an interview at an event sponsored by the Education Development Center and the National Action Alliance for Suicide Prevention, Dr. Evans discussed effective strategies for taking a population-health treatment perspective.

WASHINGTON – Suicides and opioid-related drug deaths are on parallel increases, devastating the same groups and the same communities, according to Alex Crosby, MD, senior adviser at the Centers for Disease Control and Prevention’s division of violence prevention at the National Center for Injury Prevention and Control.

Suicides increased by 25% during 2000-2015, and drug deaths – most notably, opioid-related deaths – have quadrupled since 1999. These increases strike the same groups: men, working-age adults, whites, Native Americans and Alaskan natives, and rural communities.

So consistent are the overlaps that primary care providers should view these demographics as red flags when such patients present with depression or pain complaints, Dr. Crosby said in an interview at an event sponsored by the Education Development Center and the National Alliance for Suicide Prevention. Vigilance in primary care settings is especially important, because many patients don’t have access to behavioral health specialists.

“As clinicians, we need to have a high index of suspicion, know what questions to ask, and to go a little bit deeper, beyond the presenting complaint,” he said. “Often, people with psychiatric illnesses [that predispose them to suicide and substance abuse] are going to their primary care provider first, because they don’t have access to behavioral health services. The family medicine practitioner, the internist, even the pediatrician, have to be aware of this. And clinicians need to have index of suspicion, and ask questions that go a little deeper than the presenting complaint was.”

msullivan@frontlinemedcom.com

WASHINGTON – Suicides and opioid-related drug deaths are on parallel increases, devastating the same groups and the same communities, according to Alex Crosby, MD, senior adviser at the Centers for Disease Control and Prevention’s division of violence prevention at the National Center for Injury Prevention and Control.

Suicides increased by 25% during 2000-2015, and drug deaths – most notably, opioid-related deaths – have quadrupled since 1999. These increases strike the same groups: men, working-age adults, whites, Native Americans and Alaskan natives, and rural communities.

So consistent are the overlaps that primary care providers should view these demographics as red flags when such patients present with depression or pain complaints, Dr. Crosby said in an interview at an event sponsored by the Education Development Center and the National Alliance for Suicide Prevention. Vigilance in primary care settings is especially important, because many patients don’t have access to behavioral health specialists.

“As clinicians, we need to have a high index of suspicion, know what questions to ask, and to go a little bit deeper, beyond the presenting complaint,” he said. “Often, people with psychiatric illnesses [that predispose them to suicide and substance abuse] are going to their primary care provider first, because they don’t have access to behavioral health services. The family medicine practitioner, the internist, even the pediatrician, have to be aware of this. And clinicians need to have index of suspicion, and ask questions that go a little deeper than the presenting complaint was.”

msullivan@frontlinemedcom.com

WASHINGTON – Suicides and opioid-related drug deaths are on parallel increases, devastating the same groups and the same communities, according to Alex Crosby, MD, senior adviser at the Centers for Disease Control and Prevention’s division of violence prevention at the National Center for Injury Prevention and Control.

Suicides increased by 25% during 2000-2015, and drug deaths – most notably, opioid-related deaths – have quadrupled since 1999. These increases strike the same groups: men, working-age adults, whites, Native Americans and Alaskan natives, and rural communities.

So consistent are the overlaps that primary care providers should view these demographics as red flags when such patients present with depression or pain complaints, Dr. Crosby said in an interview at an event sponsored by the Education Development Center and the National Alliance for Suicide Prevention. Vigilance in primary care settings is especially important, because many patients don’t have access to behavioral health specialists.

“As clinicians, we need to have a high index of suspicion, know what questions to ask, and to go a little bit deeper, beyond the presenting complaint,” he said. “Often, people with psychiatric illnesses [that predispose them to suicide and substance abuse] are going to their primary care provider first, because they don’t have access to behavioral health services. The family medicine practitioner, the internist, even the pediatrician, have to be aware of this. And clinicians need to have index of suspicion, and ask questions that go a little deeper than the presenting complaint was.”

msullivan@frontlinemedcom.com