Bill Overview
Title: SURS Extension Act of 2022
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: Sen. Bennet, Michael F. [D-CO]
Target Audience
Population: Health professionals in small practices with 15 or fewer professionals
Estimated Size: 600000
- The bill targets health professionals working in small practices with 15 or fewer professionals.
- It specifically focuses on those participating in the Medicare program, as it pertains to the Merit-based Incentive Payment System (MIPS) and alternative payment models.
- Since the bill mentions technical assistance, it is likely referring to both healthcare providers and their administrative staff, as they would be involved in optimizing practice systems.
- Given that it focuses on small practices, it will likely affect a substantial number of small or individual private practitioners, especially in rural and underserved areas where smaller practice sizes are more common.
Reasoning
- The SURS Extension Act directly impacts a specific subset of the population—health professionals in small practices with 15 or fewer professionals who are engaged in the Merit-based Incentive Payment System (MIPS).
- The target group will primarily comprise small practice doctors, nursing staff, and administrative personnel who handle Medicare billing.
- It's important to include a mix of individuals who represent different roles within these practices, such as doctors, nurse practitioners, and administrative staff.
- Additionally, we should consider geographical distribution—those in rural and underserved areas might have different experiences and perceptions than those in urban areas.
- The policy will not affect everyone equally; some individuals in more organized or well-funded practices may perceive less of an impact.
- The budget constraints imply that not all practices will receive equal or adequate technical assistance. Focus will likely be on those with greater need or less capability.
- The 10 interviews should include some from outside the scope to see how perceptions differ based on eligibility and impact.
- Given that the total estimated target is 600,000, we are only capturing a tiny sample here and must focus on diversity of experience within that small sample.
Simulated Interviews
Primary Care Physician (rural Wyoming)
Age: 50 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 4/20
Statement of Opinion:
- I believe the additional funds for technical assistance will help us optimize our practice.
- We often feel isolated in adopting new systems like MIPS; hence, expert guidance would be invaluable.
- Without it, we are struggling to keep up with performance metrics.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 8 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 4 |
| Year 10 | 7 | 3 |
| Year 20 | 6 | 2 |
Nurse Practitioner (suburban Kentucky)
Age: 35 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 3.0 years
Commonness: 6/20
Statement of Opinion:
- Technical assistance sounds helpful, but I'm skeptical about its reach.
- In the past, smaller practices like ours have been overlooked by federal assistance programs.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 4 |
| Year 3 | 7 | 4 |
| Year 5 | 6 | 3 |
| Year 10 | 5 | 3 |
| Year 20 | 4 | 2 |
Office Manager (urban New York)
Age: 62 | Gender: female
Wellbeing Before Policy: 8
Duration of Impact: 2.0 years
Commonness: 10/20
Statement of Opinion:
- We already perform well on MIPS, but more support is always welcome.
- Technical assistance could help us maintain our competitive edge.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 8 | 6 |
| Year 20 | 8 | 5 |
General Surgeon (rural Mississippi)
Age: 45 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 5.0 years
Commonness: 3/20
Statement of Opinion:
- This policy could relieve some administrative pressure, enabling me to focus more on patient care.
- Access to technical assistance might streamline our operation greatly.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 7 | 3 |
| Year 3 | 7 | 3 |
| Year 5 | 7 | 2 |
| Year 10 | 6 | 2 |
| Year 20 | 5 | 1 |
Family Doctor (urban California)
Age: 40 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 1.0 years
Commonness: 5/20
Statement of Opinion:
- The funding is likely more beneficial for those less tech-savvy.
- I’m interested if it offers refined guidelines or novel insights.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 6 | 5 |
| Year 10 | 6 | 4 |
| Year 20 | 5 | 3 |
Pediatrician (remote Alaska)
Age: 55 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 2/20
Statement of Opinion:
- Getting technical help is crucial due to our unique case mix.
- Any assistance for better data handling would be a godsend.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 8 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 4 |
| Year 10 | 7 | 3 |
| Year 20 | 6 | 2 |
Administrative Assistant (rural Ohio)
Age: 47 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 3.0 years
Commonness: 7/20
Statement of Opinion:
- We can make better use of these funds if the application process is simplified.
- Smaller practices sometimes struggle with compliance due to lack of staff.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 4 |
| Year 3 | 7 | 4 |
| Year 5 | 7 | 3 |
| Year 10 | 6 | 2 |
| Year 20 | 5 | 1 |
Dentist (suburban Florida)
Age: 29 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 0.0 years
Commonness: 8/20
Statement of Opinion:
- We are not heavily reliant on Medicare, but future policies might require adherence.
- It’s less applicable to dentistry, so I’m not sure how much it affects us.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 4 |
Cardiologist (urban Texas)
Age: 60 | Gender: female
Wellbeing Before Policy: 8
Duration of Impact: 2.0 years
Commonness: 12/20
Statement of Opinion:
- The patients would likely not see direct impacts from such policies aimed at smaller practices.
- Might see systemic benefits if smaller feeder practices improve.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 4 |
Physician Assistant (urban Illinois)
Age: 32 | Gender: other
Wellbeing Before Policy: 6
Duration of Impact: 4.0 years
Commonness: 9/20
Statement of Opinion:
- Assistance can streamline our wellness programs.
- Our patients rely on efficient practice management; this could benefit us.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 4 |
| Year 10 | 6 | 4 |
| Year 20 | 5 | 3 |
Cost Estimates
Year 1: $50000000 (Low: $40000000, High: $60000000)
Year 2: $52500000 (Low: $42000000, High: $63000000)
Year 3: $55125000 (Low: $44100000, High: $66150000)
Year 5: $57881250 (Low: $46305000, High: $69457500)
Year 10: $61021000 (Low: $48815200, High: $73226200)
Year 100: $100000000 (Low: $80000000, High: $120000000)
Key Considerations
- The program aims to support healthcare practices that are small and potentially less resourced than larger entities, which may face greater challenges meeting MIPS requirements.
- The funding is temporary, through FY2027, indicating that the sustainability and long-term continuation would depend on future legislative actions.
- While cost savings are not direct, improved healthcare delivery can have positive spillover effects, including increased practice revenues and decreased Medicare waste or inefficiencies.