Introduction: Every year, the cost of healthcare within the United States has continued to increase while the quality of patient care has decreased. To reconstruct the delivery of care, Congress has introduced the Medicare Access and CHIP Reauthorization Act of 2015 which has reinvented Medicare physician reimbursement systems. The purpose of this research was to study the Medicare Access and CHIP Reauthorization Act and its implementation to determine how it would financially impact rural hospitals.
Methodology: The methodology for this study consisted of a qualitative literature review. Twenty-seven research publications were utilized throughout the study. Data limited to the English language from the years 2015 through 2017 were included in the review. Results: Two reimbursement pathways termed Merit-Based Incentive Payment Systems and Alternative Payment Models have been created for physicians under the Medicare Access and CHIP Reauthorization Act. Each reimbursement pathway has rewards and penalties that affect physicians and healthcare organizations financially. In addition to the pathways, financing and competition among facilities created by the act have been expected to impact physicians and healthcare organizations.
Discussion/Conclusion: Although the long-term effects of the Medicare Access and Reauthorization Act of 2015 have not been able to be studied, physicians and healthcare organizations such as rural hospitals have been expected to be impacted significantly. Rural hospitals have been set to receive reduced government reimbursements and have been predicted to compete poorly with larger hospitals and corporations. The payment tracks available through the act have been projected to impact solo and small practice physicians negatively; therefore, hospitals have been expected to have to provide support and assistance to local clinicians.
Kelley E, Lipscomb R, Valdez J, Patil N and Coustasse A. MACRA and Rural Hospitals. Poster presented at: The Lewis College of Business Research Day; 2017 Nov 10; Huntington, WV.