To clarify MACRA's impact, we surveyed over 1,000 providers, administrators, and medical office staff. We hoped to:
- Gauge MACRA familiarity
- Focus on attitudes toward MACRA
- Measure the level of stress caused by the transition
MACRA? Hey, what did you call me?
Take it from this ancient proverb: There’s two types of health care professionals - those who doubt MACRA and those who aren’t sure.
OK. We made that up, but what we can’t make up is that half of the healthcare professionals who took our survey say they’re not at all familiar with MACRA.
Majority Don’t feel Familiar with MACRA
“I’m not sure” was the most common answer we got to every question in our survey.
Only 9% consider themselves to be very familiar with MACRA and reporting started this year.
We’re not only dealing with an industry-wide lack of preparedness, but a big ol’ lack of basic familiarity.
Eligibility is Widely Unknown
At the time of our survey, 56% of participants did not know whether they qualify to participate in MACRA’s Quality Payment Program (QPP).
However, during the survey period, CMS issued notices to physicians by mail if they’re expected participate in 2017. So we're hopeful those numbers have since improved.
Are You Eligible?
MACRA Eligibility is calculated again December 2017. Avoid a negative payment adjustment by checking your status now: https://qpp.cms.gov/
MACRA Information Not Easy to Find
We asked survey participants if they had ever encountered information on MACRA, including articles, webinars, and infographics. Most said no.
In fact, 49% said have not encountered any information on MACRA.
Note: CMS has deemed 2017 as a “Transition Year” for MACRA, which means it’s only going to get more difficult. If you’re one of many who hasn't encountered info on MACRA, start now.
MACRA Knowledge is Empowering
According to our survey, the biggest influence on how physicians feel about MACRA is their familiarity with it.
When we asked participants how they expect MACRA to impact their practice over the next three years, 63% responded - I’m not sure. Only 9% feel it will have a positive impact.
When we decided to take a closer look at responses from people who felt knowledgeable about MACRA, a pattern emerged...
The majority of healthcare professionals who are very familiar with MACRA believe it will have a positive effect on their practice over the next three years (35%). While the percentage of those who are unsure (30%) was cut in half.
Throughout the survey, we’ll take a look at how familiarity with MACRA largely impacted the responses we received.
Financial Impact
The bottom line: Medicare Part B clinicians want to know how MACRA is going to affect their financial health. We asked practices to consider MACRA’s effect on their financial well-being over the next three years.
61% said they have no idea how MACRA will affect their practice financially. The rest were divided fairly evenly among a positive, negative, or neutral outcome.
MACRA Savvy Professionals Predict a Positive Financial Impact
39% of those comfortable with MACRA believe it will have a positive impact on the financial well-being of their practice. This was a larger percentage than even the “I’m not sures,” which dropped to 31%.
Small Practices Not Confident About Their Financial Health
Financial well-being is where small and large practices begin to disagree. While the majority of both groups feel uncertain, small practices ultimately foresee a negative financial future. Large practices predict a positive one.
Administrative Impact
When it comes to reporting, the majority of professionals (58% ) have no idea how MACRA will impact their workflow. However, of those who feel comfortable making a judgement call, 27% believe they will spend more time reporting. Only 3% believe they will spend less time on reporting.
Large and Small Practices Agree: MACRA Means More Time Reporting
Both small and large practices came to a consensus in regards to reporting requirements. They feel mostly unsure about how MACRA will affect the amount of time spent on reporting, but agreed it will be more.
MACRA Savvy Confident They’ll Spend More Time Reporting
One thing’s for sure: those who know about MACRA agree about reporting requirements. While the majority (48%) expect to spend more time reporting, 25% expect their administrative burden to stay the same.
Keep in mind, the majority of these clinicians also see MACRA as being beneficial to their practice despite knowing they’ll spend more time on reporting. That’s good news!
Note: Based on CMS’s 2018 proposals, we expect the number of practices required to participate in MACRA to drop significantly in 2018. This is great news for small practices.
Impact on Quality of Patient Care
When asked how MACRA will affect the quality of care, 62% of respondents weren’t sure. The rest were split pretty between MACRA worsening, improving, or doing nothing at all to impact the quality of patient care. Long story short, there's a lot of uncertainty.
MACRA Savvy Split on Patient Care Effects
Those very familiar with MACRA were also decisively split. Some expect patient care to worsen (30%), while others expect to see it improve (28%).
Large Practices Slightly More Optimistic
When asked if MACRA would improve patient care, both small and large practices were unsure. However, those in small practices believe the care quality will suffer, large practices suspect it will improve.
Impact on Cost of Patient Care
65% of respondents feel uncertain about MACRA’s impact on the cost of healthcare for patients. However, many (20%) think it will be negative.
Respondents indicated they expect both patients and practices will shoulder the financial burden of MACRA. We expected to see everyone pick one or the other. Proof that professionals are experiencing both uncertainty and pessimism about MACRA.
Small and Large Practices Unsure About Cost
When it comes to patient care, small and large practices are both unsure how MACRA will affect costs. Small practices, however, think it’s more likely to have a negative impact while large practices are split equally between positive and negative outcomes.
MACRA Savvy Think Patients Less Likely to Benefit
Those who know more about MACRA were split fairly evenly about the future cost of healthcare for patients. 32% think it will have a negative impact on the price of care, but that’s only slightly more than those who weren’t sure (28%).
Specialty Spotlight: Mental Health
Many who responded to our survey identified as mental health professionals, so we’ve added the following specialty-specific analysis.
We included anyone who labeled their specialty as licensed professional counseling, neurology, neuropsychology, mental health, psychiatry, or psychology.
Nearly 60% of our mental health professionals are practice owners and 58% work in 1-3 provider practices.
Majority of Mental Health Professionals Not Familiar with MACRA
According to our survey, more mental health professionals feel unfamiliar with MACRA (56%) than the general population. Only 4% said they felt very familiar.
57% do not currently use the Physician Quality Reporting System (PQRS).
Mental Health Professionals Less Optimistic about MACRA
Mental health professionals are largely uncertain about what to expect as a result of MACRA. More than half (70%) could not decide how the switch to value-based care would impact their practice, while just 2% said they expect the outcomes to be positive.
The majority (72%) was also unsure how changes brought on by MACRA will impact the amount of time spent on reporting.
Note: 60% of mental health professionals say they have not encountered any information on MACRA.
When asked about MACRA’s impact on the cost of healthcare, 76% of mental health professionals said they were unsure, but many (14%) expect it to be negative. We also asked for their thoughts on how MACRA would impact the quality of care and received a similar response.
The Advantage of Understanding MACRA
Though the numbers seem bleak, there is one positive take away: Professionals, who understand MACRA, are increasingly optimistic.
It may seem like an obvious conclusion, but it’s a necessary one. And we have the data to back it up.
We discovered that despite knowing they’ll spend more time reporting, respondents who are very familiar with MACRA believe it will ultimately have a positive impact on their practice over the next three years.
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