Physicians’ Readiness for MACRA

By July 10, 2017Commentary

Physicians are realizing that the new Medicare reimbursement mechanism, which pays them more for being in an “Advanced Alternative Payment Model”  or for doing certain quality reporting, is the here and now, and many are scrambling to figure out how to maximize reimbursement and comply with the requirements, according to a survey from the American Medical Association and KPMG.   (AMA/KPMG Survey)   A lot of doctors may not have realized it, but 2017 is actually the first measurement year for the payment changes that kick-in in 2019.  1000 practicing physicians were surveyed about their knowledge of the new requirements and their preparation for it.  51% said they were somewhat knowledgeable about the new payment mechanism, but only 8% said they had a deep familiarity with it.  As you might expect, generally doctors in larger practices have more familiarity, but those in very large practices or in employment situations are less likely to be knowledgeable, likely reflecting that in those settings, there are other people assigned to maximize compliance.  56% of physicians said they plan to participate in the quality reporting arm of MACRA, while 18% say they expect to meet the Alternative Payment Model requirement.

Around 70% have been preparing to meet the reporting requirements for MACRA’s Quality Payment Program in 2017.  (It is important to note that there is a significant number of doctors for whom Medicare is a small enough part of their practice that they don’t care about penalties and incentives.)  53% of those physicians who said they are prepared to report in 2017 said the MACRA requirements are very burdensome.  Most are planning to only meet the minimal requirements for reporting, with 30% planning to do full reporting.  Most plan to use their EHR or a qualified clinical data registry for reporting purposes.  Two-thirds of doctors have gotten some training on the MACRA requirements, most often from their work setting.  The time involved in MACRA compliance is the biggest concern expressed by doctors in regard to implementation, which is not surprising since most physicians already feel overburdened by administrative tasks.  While recognizing the importance of the change to their practice’s financial success, a large majority feel unprepared to maximize revenue under MACRA.  Given that private payers often follow Medicare’s lead in reimbursement, it appears that many physicians are in for a challenging few years as they adapt to the new payment regime.

Kevin Roche

Author Kevin Roche

The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry through Roche Consulting, LLC. Mr. Roche is available to assist health care companies through consulting arrangements and may be reached at khroche@healthy-skeptic.com.

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