Getting Paid for a Unicorn

The Centers for Medicare & Medicaid Services (CMS) is giving out millions of dollars to help small practices succeed in the QPP.  What is the  QPP?  Well, it’s the Quality Payment Program, silly, and it is more elusive than the unicorn or Bigfoot.  Here is the plan:

These groups will provide hands-on training to help thousands of small practices, especially those in historically under-resourced areas, including those that are rural, have a shortage of health professionals, or are medically underserved. For example, clinicians will receive help choosing and reporting on quality measures, as well as guidance with all aspects of the program, including supporting change management and strategic planning and assessing and optimizing health information technology. The training and education resources will be available immediately, nationwide, and will be provided at no cost to eligible clinicians and practices.

So, let’s summarize.  Docs in “historically” under-resourced, rural areas who are overwhelmed will get to learn about reporting quality measures, supporting strategic planning and optimizing health information technology.

And all the docs really want is some extra help in the clinic and more pay for a brutal job.

Sounds like a winner!  Thank you, government.


Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  4 comments for “Getting Paid for a Unicorn

  1. Kurt
    March 13, 2017 at 8:42 am

    Sorry folks, I don’t care how many alphabet “Quality Assurance” agencies are created.
    It’s all a waste of money. Until patients are held accountable for their lousy health behaviors,
    nothing is going to change. The public aiders who get their care for free keep smoking and eating
    garbage. Most of them you can take all the “medical education” time you want and they’ll take the 120 pages of self help information you printed off with “A.D.A.M.” and use it to start the wood stove. Yeah, there’s a lot I can do in 15 minutes!

  2. Steve O'
    March 6, 2017 at 1:58 pm

    I love the thoughts of the great thinkers! They have discovered “potential payment cliffs” and handle the problem with MIPS. Wasn’t that the answer to a question on the Bubble Boy episode of Seinfeld? (Sorry, it’s the MOOPS.)

    “To potentially earn a positive payment adjustment under MIPS, send in data about the care you provided and how your practice used technology in 2017 to MIPS by the deadline, March 31, 2018. In order to earn the 5% incentive payment by significantly participating in an Advanced APM, just send quality data through your Advanced APM.” You are guaranteed that “Depending on the data you submit by March 31, 2018, your 2019 Medicare payments will be adjusted up, down, or not at all.” But not sideways, inside-out or flung into an imaginary dimension!

    Fortunately, there’s the APAS – the Abject Patient Abandonment System. Now, if you schedule patients, you are allowed to cancel 10% of their visits without prior announcement and without penalty, so that you can attend to the critical paperwork! Of course, you don’t get paid for cancelled patient visits, you silly little fraudster! But you are sheltered from liability if the unseen patient dies or whatever. They were, after all, sick or something when they made the appointment!

    CMS has the goal of TNCOP – Total Non-Care of Patients – by the year 2020. If you provide no care, think of how big your panel size can be!

    We are approaching what the neurologists call the “locked-in syndrome.” The patient is awake and alert, but cannot do anything. One person’s nightmare is a bureaucrat’s dream!

  3. Hawgguy
    March 6, 2017 at 9:55 am

    You guys nailed it. I practice rural/underserved. We get hammered; everything from childbirth to geriatrics. Feel-good government mentoring will not substitute for Benjamins. Hard to recruit qualified people to live in BFE and commit without some sort of inducement.

  4. Pat
    March 6, 2017 at 7:57 am

    I live in one such area, here it has been very difficult to recruit actual physicians. The ones we seem to get are marginal players, and we end up staffing with mid-levels. Apart from the money coming into a designated critical access hospital, the overall environment for primary care is awful, and no amount of “free”, “quality” teaching by non-clinical drones will do anything to improve actual care access around here. No doubt this is another make-work program whose supporters will brag to Congress about all the good they did while begging to blow more money.

    Although I’m sure “supporting change management” is as thrilling as it sounds.

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