brand logo

Am Fam Physician. 2016;93(12):968

CMS Says It's Prepared to Help Small Practices Navigate MACRA Changes

The Centers for Medicare and Medicaid Services (CMS) recently released a resource aimed at physicians in small practices, many of whom have expressed significant concerns about the disproportionate burden on them as a result of the Medicare Access and CHIP Reauthorization Act (MACRA). The fact sheet, “Flexibilities and Support for Small Practices,” notes that “CMS is sensitive to the unique challenges that small practices face in different types of communities, and the Quality Payment Program, as proposed, would provide accommodations for various practice sizes and configurations.” Regarding the Merit-based Incentive Payment System (MIPS), one of two payment paths physicians may pursue, CMS outlines specific proposed flexibilities designed to account for diversity among practices. For instance, CMS highlights proposals that are small practice–friendly, such as low-volume exclusions from the MIPS payment adjustment for clinicians or groups who have $10,000 or less in Medicare charges and 100 or fewer Medicare patients; flexibility in MIPS scoring if there are not sufficient measures and activities applicable and available in a performance category; and group reporting that allows small practices to join virtual groups and combine their MIPS reporting. The agency notes that the legislation provides $100 million in funding to help small practices with technical assistance and another $685 million to support the Transforming Clinical Practice Initiative. For more information, go to

Family Physician Salaries Increase, but Still Trail Those of Other Subspecialists

Family physicians are earning more than they did last year, with salaries that are growing faster than those for most other subspecialists, according to an annual survey on physician compensation. Still, the income gap between family physicians and other subspecialists remains wide. Overall, primary care physicians—and family physicians, specifically—earn an average of $195,000 per year, compared with $284,000 for physicians in other subspecialties, according to the 2015 Medscape Physician Compensation Report. Pediatricians were the only subspecialty with a lower average salary, at $189,000 per year. However, salaries for family physicians rose 10% between 2014 and 2015, the fifth highest rate of increase for any subspecialty. For more information, go to

Free Webinar Addresses Influenza Vaccination in Older Adults

Family physicians can learn the latest information on influenza vaccines, particularly those used in patients 65 years and older, by viewing a free, 30-minute webinar from the American Academy of Family Physicians. The webinar covers how family physicians can increase influenza vaccination rates in their practices, especially in older adults. Panelists review data on morbidity and mortality, as well as on the effectiveness of the standard and high-dose influenza vaccines. Resources to help increase accuracy and revenue when coding and billing for vaccinations are also shared. The webinar explains which vaccines will be available in the 2016–2017 influenza season and how their composition has changed from those used during the previous season. It also highlights available data on the high-dose vaccine indicated for older adults. Additionally, viewers can learn about a new seasonal influenza vaccine containing an adjuvant that the U.S. Food and Drug Administration approved last year. For more information, go to

Harvard Medical School Takes Case Study Approach to Primary Care

Researchers at Harvard Medical School's Center for Primary Care are preparing comprehensive case studies to highlight best practices while illustrating how effective primary care teams are transforming practices. When the project is complete, the research will be part of the Harvard Medical School curriculum for the next generation of students. The researchers considered more than 120 sites for possible inclusion as a case study. They are narrowing them to 10 to 15 sites by weighing factors such as geography, payment model, level of innovation, and outcomes. Although the Harvard Business School library has case studies about other physician specialties, Erin Sullivan, PhD, the center's research and curriculum director, said she knew of no case studies of this scope dedicated to primary care. Sullivan believes measurements of health outcomes are especially valuable for investigating how practices identify and solve problems. For more information, go to

— AFP and AAFP NEWS staff

For more news, visit AAFP News at

Continue Reading

More in AFP

Copyright © 2016 by the American Academy of Family Physicians.

This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP.  See permissions for copyright questions and/or permission requests.