CPM Spring 2019 - 25

daup h i n c m s .o rg

Because the PAMED House of Delegates
Anecdotal market feedback also suggests
In addition to the economic returns
includes many frontline physicians, unease that many physicians have adjusted to described above, it could be argued that
about MACRA became quickly evident. the law's onerous provisions. As a result, there were additional benefits to PAMED.
One year after the formation of The Collab- physician anger - while ever present - has Participant surveys of both practice manorative, a stump speech by an AMA leader receded from view and there is less interest agers and physicians demonstrated high
at the 2017 House of Delegates was met by in new MACRA reporting options.
levels of satisfaction with the Society. At
highly skeptical Q&A over the "checkbox
an anecdotal level, there were expressions of
medicine" dimensions of MACRA. And
In addition to these many market gratitude from physicians who were feeling
in the 2018 House, Resolution 18-306 on realities, reversal of support from the overwhelmed by MACRA's onerous man"the repeal of MIPS" was adopted.
House of Delegates, participation of The dates. It also established a customer base for
Collaborative's CEO in House proceedings follow-up efforts to recruit physicians into
This was ultimately of no surprise to The and feedback from the County Medical PAMED and into The Collaborative's CIN.
Collaborative's personnel, who became Societies led to the decision to significantly
aware of PAMED member antipathy about reduce marketing resources or staff time
However, the good news of physician
MACRA throughout 2017. While phy- to support or expand its MIPS offering.
support and increased good will for PAMED
sicians appreciated help with their MIPS
was overshadowed by significant grass
reporting, lingering physician unease about
The Collaborative is not sitting still, roots hostility to MACRA. While the
the underlying law led to questions about however. As it recruits physicians to its intent of the law was arguably good, and
why The Collaborative wasn't doing more clinically integrated network (the "PA the elimination of the SGR was a victory,
to reduce MIPS reporting. This prompted Clinical Network"), a second MACRA physician dismay over the reporting proa LinkedIn blog post in October of 2017 reporting option has become available to visions generated a backlash in the market
that echoed physician unhappiness and was participants through the CIN's population that blurred the line between being part
critical of the AMA's continuing support health platform.
of the solution (help with MIPS) versus
of the law. The Collaborative's Twitter
being part of the problem (enabling MIPS).
account was used to draw attention to DISCUSSION
it. Feedback from the AMA prompted
The "investment" by PAMED through
This too is a lesson: physician interest and
deletion of that post and an email of The Collaborative netted over $2.3 million support can evaporate and overshadow any
apology to Dr. McAneny, then President in economic gains for physicians. While a upside benefits of the best laid plans. As
Elect of that organization.
conventional investment strategy would organizations like PAMED rise to meet the
have generated significant income for tumultuous changes in healthcare, being a
PAMED's operations that would have also force for good when things could go bad calls
Over the last year, the "MACRA market" ultimately served Pennsylvania physicians, for being close to your membership, being
has become saturated by other service the ROI of 340% suggests that this alter- ready to adapt, accepting responsibility and
entities such as EHR-based and other native investment strategy through The communicating status reports frequently.
information technology vendors, many Collaborative benefitted community-based
of which were also endorsed by other physicians in a direct and meaningful way.
organized medicine associations. The
Collaborative's "MIPS solution" became
Other than PAMED's successful tort
one of many incumbent businesses with reform efforts (including the MCARE
a stable, if small, market presence.
refund of 2014 and the beneficial impact
on insurance premiums from delaying the
During this time, the Trump Adminis- recent venue rule proposal), we are unaware
tration used physician feedback to create of any other instance in which PAMED
multiple reporting exemptions to MACRA. generated this level of return on behalf of
This has helped reduce the burden on small its members and for the type of practices
physician-owned practices, which were that most needed help at the time. Tort
a focus of The Collaborative's activities. reform and the response to MACRA may
This further hampered the ability of The offer a model as future opportunities arise
Collaborative to grow market share.
for organized medicine to positively deploy
intellectual or financial capital in service
to its physician membership.

Central PA Medicine Spring 2019 25


CPM Spring 2019

Table of Contents for the Digital Edition of CPM Spring 2019

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