Physicians Worry About Preparedness and Financial Impact of MACRA

Independent physicians – once and still the backbone of the US healthcare economy – are claiming to have trouble with their mulling of MACRA and what its Quality Payment Program will require of their practices. Clear enough, even though many don’t believe MACRA is all that clear.

But fear, which seems to be making up quite a bit of the healthcare landscape the past decade or so – Meaningful Use; EHR technology; 5010; ICD-10; and now MACRA – won’t keep this group of physicians from trying to move forward as best they can by navigating the regulation.

According to a recent study conducted by Kareo, an overwhelming 84 percent of independent physicians and staff said they are uncertain about the future of the regulation, but that won’t hold them back from trying to participate in it to the best of their ability.

“With payment adjustments potentially reaching plus or minus nine percent by 2022,” a statement about the research stated, this is good news. It means that most practices intend to do what is necessary to avoid an adjustment and/or try to get an incentive.

The survey may have been measuring the initial shock of MACRA as the questionnaire was conducted shortly after the final rule was released in October 2016, but more than 170 medical practices responded, suggesting a sound sample size.

“The overall results show that most practices expect to participate, but they still aren’t sure what the requirements are or how the program will impact revenue,” researchers reported.

Practitioners were asked if they understood what MACRA requires of their practice, 41 percent said they were not sure and 43 percent said they disagreed or strongly disagreed. Only 4 percent said they strongly agreed that they knew what MACRA required of them. So, these results, at least at the time the data was collected doesn’t speak highly of the Center for Medicare and Medicaid Services’ rollout or educational campaign related to the initiative.

The report also notes that similar results were identified when these physicians were asked about the impact on revenue – 63 percent said they weren’t sure if MACRA would reduce reimbursement. When asked about whether MACRA would increase reporting burdens, most were sure it would, which is likely a given since this is a federal government program. More than 60 percent said the reporting requirements would increase for their practice.

“Independent practitioners want to stay independent so they want to participate in programs like MACRA and avoid possible penalties,” said Dan Rodrigues, founder and CEO of Kareo.

According to CMS, the Quality Payment Program is meant to make “Medicare better by helping you (physicians) focus on care quality and the one thing that matters most – making patients healthier.

The Quality Payment Program has two tracks you can choose from: the Merit-based Incentive Payment System (MIPS) and the Advanced Alternative Payment Models (APMs).

The final MACRA rule came out on October 14, and it stated that the reporting period would begin on Jan. 1, 2017, for those who want to fully participate and try to get a positive payment adjustment; in other words, a pretty quick rollout for an awesomely large change in the medical landscape.

“Our survey highlighted that independent practices want to comply but they are struggling with the complexity and aggressive timing of the rule,” said Rodrigues.

Scott Rupp's picture

Scott Rupp


Scott E. Rupp is a writer and an award-winning journalist focused on healthcare technology. He has worked as a public relations executive for a major electronic health record/practice management vendor, and he currently manages his own agency, millerrupp. In addition to writing for a variety of publications, Scott also offers his insights on healthcare technology and its leaders on his site, Electronic Health Reporter.

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