Survey: Half of physicians have never heard of MACRA

Despite its promise to fundamentally shift how Medicare payments are tied to the cost and quality of care, a recent survey has found that about half of the physicians who took part were unaware of the upcoming update in the Medicare Access and CHIP Reauthorization Act, also known as MACRA.

According to the Deloitte Center for Health Solutions 2016 Survey, which polled 600 physicians in the United States on their opinions of the update’s implications and the coming changes, just 50% of non-pediatric physicians had heard of MACRA. The survey also found that 21% of self-employed physicians and those working in independently-owned practices reported they there “somewhat familiar” with the law. Among physicians employed by hospitals, health systems or their affiliated medical groups, that figure was 9%.

“The changes associated with MACRA are fast approaching,” Anne Phelps, principal at Deloitte & Touche LLP, said in a press release. “The first performance reporting period begins Jan. 1, 2017. The fact that so many physicians and clinicians still haven’t heard of the law means they’ll have a lot of work to do over the next 5 months, including evaluating current payment processes and understanding how physicians are organized within their hospitals or practices.”

Rather than the current patchwork of programs currently in place measuring the value and quality of care, the new proposed rule, announced by CMS last spring, would implement previous efforts by Congress to streamline those programs through a framework called the Quality Payment Program. The program includes two paths: The Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs).

The law allows clinicians to develop new care models and encourages new collaborations between plans and hospitals.

The proposed rule aims to streamline and reduce the reporting burden across these categories, according to HHS. CMS would begin measuring performance for physicians and clinicians through MIPS in 2017, with payments based on those results beginning in 2019.

Officials from various medical professional organizations, including the AMA and the American College of Physicians, have expressed optimism regarding the new MACRA rule, stating it will simplify what they have characterized as a significant administrative burden and lack of flexibility in meeting the requirement of quality reporting. They have also said it will help alleviate the issue of physician fatigue. However, the AMA has also recommended changes to the rule.

However, the Deloitte survey found that nearly eight out of 10 physicians prefer traditional fee-for-service or salary as compensation.

“This means many physicians will likely have to adjust their current approach and practice management based on MACRA’s specifications,” Deloitte stated in the press release

Also on the minds of the physicians surveyed was the specter of increased financial risk. According to Deloitte, 58% said they would opt to be part of a larger organization to insulate themselves from potential financial risk, and to gain full access to various resources and capabilities. In addition, 80% said they expect MACRA to drive physicians to join larger organizations and networks.

“MACRA is what can make value-based care real,” Mitch Morris, Deloitte principal, said in a press release. “It’s exciting, but also challenging.”

The Deloitte Center for Health Solutions is the research division of Deloitte LLP’s life sciences and health care practice. According to the company, its goal is to “inform stakeholders acress the health care system about emerging trends, challenges and opportunities.”

Additional reading:

http://www2.deloitte.com/us/en/pages/life-sciences-and-health-care/articles/macra.html