The Pharma Sales Interview Breakthrough Blog
While the final ruling on this proposal has yet to be complete, the Medicare Access and Chip ReAuthorization Act (MACRA), represents a significant shift for providers in how they are reimbursed through Medicare.
Ultimately, there will be 2 paths for providers - participate in MIPS or participate in and Alternative Payment Model. (APM). Please note that not all APMs exempt a practice from MIPS. In fact, for the first 2 years of the Oncology Care Model(OCM), practices will need to participate in MIPS even if that are in the OCM...because it is not recognized as exempt until practices are participating in the 2 sided risk share of the OCM. That won't be an option for OCM sites until 2018.
That said, onus of MIPS will primiarly fall on the primary care providers because they will be "attributed" or own the the patients. More often than not...the specialists will likely have a very small pool or no pool at all of "attributed" patients that impact their payments through MIPS.
All that said, below is a video presenation by CMS explaining MACRA and MIPS. I will comment more on this in future posts, but it's important for you because Medical/Pharma companies have to adjust to this new world. The traditional clinical outcomes of a drug will always remain important...but other outcomes will become equally as important...such as "reductions in hospitalization".
As you prepare for a medical sales interview, think about this impact this has on what's truly important to the physician offices. Health care providers will be under more stress and scrutiny to be effective and efficient with their time....you knocking on their office door delivering the same message as before is not efficient or effective. You have to bring value to them...and what that value is will be something you have to determine. I'm guessing that components of MIPS or APMs will be on the forefront of their mind and should be on yours as well.
As you watch the video below, pay close attention to the portion that outlines future payments for those that participate in MIPS vs. APMs. Enjoy!
The "Breakthrough" Book