- All 800 specialty physicians surveyed in June by Integra Connect stated that they have yet to fully comprehend MACRA, resulting in few specialists investing in the capabilities needed for MACRA implementation.
While 100 percent of the specialists are still working through MACRA, about 71 percent also said that they are learning about the new value-based reimbursement program, but still have a way to go.
“The data shows that an increasing number of specialty physicians are realizing that the transition to more holistic management of patients in support of MACRA will require fundamental changes,” stated Charles Saunders, Integra Connect CEO. “The challenge is that few are taking the necessary actions to ensure success.”
The survey’s results echoed findings from other recent surveys evaluating MACRA knowledge among providers and healthcare executives. A recent American Medical Association (AMA) survey from June 2017 revealed that providers involved in their practice’s decision-making process are split on how well they understand MACRA.
About one-half of respondents stated that they were somewhat knowledgeable about MACRA implementation and the Quality Payment Program, whereas 41 percent said they had heard of MACRA, but would not consider themselves knowledgeable.
Healthcare executives expressed more confidence than providers, with 61 percent of finance executives in a Nuance Communications survey stating that they understand MACRA.
However, of the executives who said they were somewhat or very confident with their MACRA knowledge, over three-quarters could not correctly identify the greatest penalty eligible clinicians could receive in 2019 under MACRA’s Merit-Based Incentive Payment System (MIPS)
Another 35 percent of those who felt at least somewhat knowledgeable also did not know that MIPS requires at least 90 days of quality data to be submitted to the program for full points.
MACRA understanding may be lacking across providers and leaders, but specialists are particularly behind with MACRA implementation and preparation. Almost one-quarter of those surveyed by Integra Connect reported that they have not started preparing for the program despite its launch at the start of the year.
Only 17 percent of providers in the AMA survey said they had not started preparing.
To prepare for MACRA implementation, specialists intend to engage in the following activities:
• 40 percent are taking a do-it-yourself approach by leveraging existing resources and tools
• 25 percent plan to invest in consulting services
• 23 percent expect to invest in new care coordination services
• 21 percent intend to install a new EHR
However, specialists expressed concerns about funding their MACRA implementation plans. About 62 percent stated that they do not know how or have no concrete plans to fund the resources needed to succeed with MACRA and MIPS.
They also voiced concerns about their resources. Approximately 51 percent of respondents stated that their practice is not prepared to support value-based care with their current EHR system.
The respondents also identified their top barriers to MIPS success, with employing the right individuals with the right skills being the greatest challenge.
Approximately 20 percent of specialists also identified understanding MIPS requirements as a top obstacle, followed by spurring a cultural shift toward value-based care with 19 percent of respondents.
MACRA implementation and MIPS requirements also prompted providers in a recent MGMA survey to pinpoint the value-based reimbursement program as the top most burdensome regulation for providers. Eighty-two percent of respondents labeled MACRA as “very” or “extremely” burdensome.
Providers in the MGMA survey were particularly worried about the clinical relevance of MIPS and the Quality Payment Program in general.
Despite a lack of readiness, over one-half (56 percent) of participants in the Integra Connect study still intend to generate cost savings from practice transformations for MACRA.
“To maximize clinical and financial returns under MACRA, these practices will need a combination of comprehensive technology designed for their needs, process improvements and dramatic cultural change with new skill sets such as care management and navigation at the core,” Saunders stated.