Sharon V. – BASIS Tucson North

BASIS Tucson North Senior Sharon V.

MACRA and MIPS in a Medical Business

Project/blog link: MACRA and MIPS in a Medical Business
BASIS Advisor: Mr. Quinlin
Internship location: Catalina Pointe Arthritis Rheumatology

Project Abstract

Health care in the US is very complicated and expensive. The purpose of my project is to understand how different health care insurance models (Commercial, Medicare, and Medicaid) work. I will specifically study the efficiency, effectiveness, and value of the new APMs (Alternative Payment Models), and MIPS (Merit-Based Incentive Payment Systems) programs which are part of the new Medicare Payment Reforms for physician reimbursement as per MACRA (Medicare Access and CHIP Reauthorization Act of 2015). I will intern with the business associates of Catalina Pointe Arthritis and Rheumatology Clinic to better comprehend the medical business model for a small specialty clinic and how the proposed reimbursements will affect them. I will scrutinize whether these new payment models can optimize the treatment and management outcomes for patients as well as continue adequate reimbursement of physicians and medical services. The new health care payment programs will greatly affect the ways by which medical establishments will try and provide the best care for the most reasonable price. At the internship I will also learn the microeconomics involved in running a medical business office. At the end of the internship, I will write a paper discussing what I learned about medical economics and the newly proposed health care payment programs.

MACRA and MIPS in a Medical Business