- Approximately 77 percent of practices of three or more clinicians are looking to purchase Merit-Based Incentive Payment System (MIPS) compliance technology by the last quarter of 2017 to overcome MACRA implementation challenges, a recent Black Book Research survey revealed.
Eighty-nine percent of the 8,845 surveyed physician practices primarily wanted to implement MIPS compliance technology because they could not identify their practice’s potential MACRA incentive payments or penalties.
“Given the magnitude of the changes, the hunt is on for the best MIPS incentive enablement resources,” stated Doug Brown, Black Book’s Managing Partner.
Small physician practices and solo providers anticipated facing more MACRA implementation challenges than their larger counterparts, prompting practice leaders to seek MIPS compliance solutions. The survey uncovered the following MACRA obstacles:
• 81 percent of independent providers in practices of four or more clinicians said they do not understand how to align data with MIPS measures
• 68 percent of solo clinicians perceived MACRA as a “burden or bust to their independent practice” by 2020
• 75 percent of independent providers were weighing whether to sell their practices to hospitals or larger medical groups to decrease administrative burdens and costs stemming from MACRA implementation
• 66 percent of hospital-affiliated physicians reported feeling unprepared for MACRA implementation without hospital, IDN, or group practice assistance
• 67 percent of small practices and 82 percent of rural providers are considering joining an accountable care organization to boost their MIPS scores
In response to MACRA implementation challenges, large and small physician practices are turning to consultants and vendors for MIPS compliance support.
Eighty percent of survey participants agreed that taking inventory of legacy health IT systems is crucial to identifying how existing EHR and data analytics tools can support MIPS reporting. MACRA consultants have been key players in performing health IT inventory for practices, Brown mentioned.
But MACRA consultants may be difficult to obtain because of high demand and costs. Roughly three-quarters of practices with three or fewer physicians struggled with health IT basics, but said they could not afford to hire a consultant in 2017.
Other physician practices planned to outsource MIPS compliance support to help them catch up on MACRA implementation. About 80 percent of practices reported that they do not have a MACRA implementation strategy, but they expected software or an outsourcer to help them implement one in 2017.
Some providers (22 percent) waited to create a MACRA implementation strategy because they thought the program would be delayed. As a result, 91 percent of those who delayed MACRA implementation planning stated that they cannot find qualified health IT staff to successfully participate in the Quality Payment Program this year.
In addition to consultants and outsourcing, 83 percent of practices that use the top EHR systems were considering EHR optimization projects to support MIPS compliance.
Although 72 percent of respondents with EHR systems outside of the top eight largest systems said they were not partnering with their EHR vendor for MIPS compliance.
A lack of EHR optimization may spell trouble for these practices. Eligible clinicians must use 2015 certified EHR technology by 2018 for MIPS reporting. Practices using smaller EHR vendors may not meet this requirement if their vendor has not developed 2015 certified products.
“It is imperative that providers grasp the requirements of MACRA now to ensure they put the right strategy in place, since the pace of the program only accelerates in 2018 and beyond,” cautioned Brown.
While practices search for MIPS compliance support, many practice leaders are struggling to find vendor solutions. Approximately 92 percent of the surveyed practices did not know of any branded MIPS compliance technology from vendors besides their EHR companies that supported all registry measures for 2017.
However, “finding one-stop solutions shop for MIPS support is becoming easier with quality measure monitoring dashboards and enterprise analytics vendors,” Brown noted.
Black Book survey respondents who were already gathering 2017 MIPS data sets named SPH Analytics as the top MACRA support technology vendor.
Other MIPS compliance vendors mentioned by provider organizations in the survey included Viewics, IBM Watson Health, Caradigm, Health Catalyst, SA Ignite, Care Cloud, Optum, Mingle Analytics, Equation Health (nThrive), Meridian Precision BI, Modernizing Medicine, DocsInk, MedeAnalytics, Ingenious Med, Lightbeam, MIPSWizard and XCare.