Bill Overview
Title: SURS Extension Act
Description: This bill reauthorizes funds through FY2027 for the Centers for Medicare & Medicaid Services to contract with specified entities (e.g., quality improvement organizations) to provide technical assistance regarding the Merit-based Incentive Payment System (MIPS) and alternative payment models under Medicare, specifically for health professionals in practices with 15 or fewer professionals. (MIPS is an incentive program under Medicare that allows health professionals to receive payment adjustments based on certain performance measures.)
Sponsors: Rep. Welch, Peter [D-VT-At Large]
Target Audience
Population: health professionals in small practices, specifically those in underserved and rural areas
Estimated Size: 1000000
- The bill aims to assist health professionals working in small practices, particularly those in underserved and rural areas.
- It affects those who participate in the Merit-based Incentive Payment System (MIPS) under Medicare, which is part of a performance-based payment adjustment scheme.
- The bill specifically indicates targeting practices with 15 or fewer professionals.
Reasoning
- The target population includes health professionals in small practices, particularly in underserved and rural areas. This is a highly specific group, making up about 10-15% of healthcare professionals in the U.S. The policy aims to provide technical assistance to improve their performance in MIPS, which could directly impact their financial stability and workload.
- A range of experiences will be represented to account for variation in practice size, location, and personal views on the policy.
- Since the budget is limited, not all eligible professionals may receive assistance, highlighting the need to consider both those who benefit and those who do not.
Simulated Interviews
Family Nurse Practitioner (Rural Arkansas)
Age: 35 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 8/20
Statement of Opinion:
- I support the policy as it might ease some financial burdens and allow us to focus more on patient care.
- Technical assistance could help with the complex requirements of MIPS.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 5 |
General Practitioner (Urban New Mexico)
Age: 50 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 5.0 years
Commonness: 5/20
Statement of Opinion:
- Support for small practices is crucial.
- Any assistance in understanding MIPS could relieve stress and improve my practice's financial situation.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 7 | 4 |
| Year 10 | 7 | 4 |
| Year 20 | 6 | 4 |
Physician Assistant (Suburban Ohio)
Age: 28 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 6.0 years
Commonness: 10/20
Statement of Opinion:
- This policy could offer our clinic valuable support.
- Navigating MIPS metrics is complex and could use professional assistance.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 5 |
Internal Medicine Doctor (Rural Texas)
Age: 40 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 7.0 years
Commonness: 7/20
Statement of Opinion:
- This has the potential to significantly help solo practitioners.
- Support with MIPS would relieve current bureaucratic burdens.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 7 | 4 |
| Year 5 | 8 | 4 |
| Year 10 | 7 | 4 |
| Year 20 | 6 | 4 |
Pediatrician (Rural Pennsylvania)
Age: 63 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 6.0 years
Commonness: 12/20
Statement of Opinion:
- We appreciate policies that support smaller practices, but I am not sure how impactful this will be for us.
- Maybe the technical support would translate to better resource management?
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 7 | 7 |
| Year 20 | 6 | 6 |
Dentist (Underserved Urban California)
Age: 45 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 4.0 years
Commonness: 9/20
Statement of Opinion:
- Support would be welcome, but we need more targeted assistance for dental practices.
- Hopefully, it may ease the shift toward workable payment models.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 5 | 5 |
| Year 20 | 5 | 5 |
Midwife (Underserved Kentucky)
Age: 52 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 7.0 years
Commonness: 8/20
Statement of Opinion:
- I hope it helps alleviate some administrative burdens.
- Clarifying MIPS requirements can allow us to focus more on patient care.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 5 |
Chiropractor (Rural North Dakota)
Age: 30 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 6/20
Statement of Opinion:
- This policy is appealing in promoting practice growth.
- Financial incentives could be beneficial to our business.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 5 | 5 |
Allergist (Urban Alabama)
Age: 48 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 4.0 years
Commonness: 10/20
Statement of Opinion:
- Mixed feelings - could use help with metrics but unsure of overall impact.
- Valuable assistance could indeed optimize our performance evaluations.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 5 | 5 |
| Year 10 | 5 | 5 |
| Year 20 | 4 | 4 |
Optometrist (Rural Colorado)
Age: 39 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 7/20
Statement of Opinion:
- Optimistic about greater support for small practices.
- Hoping it will help us navigate MIPS more effectively.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 5 |
Cost Estimates
Year 1: $25000000 (Low: $20000000, High: $30000000)
Year 2: $26000000 (Low: $21000000, High: $31000000)
Year 3: $27000000 (Low: $22000000, High: $32000000)
Year 5: $29000000 (Low: $24000000, High: $34000000)
Year 10: $32000000 (Low: $27000000, High: $37000000)
Year 100: $75000000 (Low: $70000000, High: $80000000)
Key Considerations
- The reauthorization is for targeted support to improve healthcare quality via incentive payment systems, crucial for Medicare cost management, especially in rural and underserved areas.
- Regulatory or funding changes can impact how MIPS operates, thus modifying projected costs.
- Inflationary adjustments to funding are necessary to maintain the initial impact of support programs.