10 top MACRA trends challenging providers

Published
  • May 09 2017, 4:00am EDT

Shift to MACRA prompts providers to look for IT solutions

Black Book Research used crowdsource techniques to survey 8,845 physician practices from February through April as it sought to assess how the new MACRA quality payment program, which includes the MIPS program, is challenging physicians as they move toward valued-based care, and the collection and reporting of quality metrics. Here is a look at the findings.

The MIPS compliance technology market is booming

Some 77 percent of practices with three or more clinicians are looking to buy MIPS compliance software by the end of this year. However, 92 percent were not aware of any branded technologies that support all MIPS registry measures for 2017 reporting, besides their electronic health record. Most wanted MIPS software not necessarily for quality measurement but to decipher MACRA earning potential.

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MACRA sparks ambulatory EHR optimization

More than 80 percent of users of the largest systems are upgrading or optimizing their systems, which include those offered by Cerner, Epic, Allscripts, eClinicalWorks, NextGen, athenahealth, Practice Fusion and GE Healthcare. Nearly three-quarters of those not using these systems are not working with their vendor to ensure MIPS preparation. Further, physicians in 2018 must use EHRs certified for 2015 requirements, and these smaller vendors may not be certified.

Business will be good for MACRA consultants

Some 80 percent of responding practices agree that performing a technology inventory is critical to seeing how far their current EHR and other systems can take them. “MACRA consultants are busy identifying and developing tools to support innovative projects as well as to bring clinicians on board as quickly as possible, but it is hard to contract currently because of demand,” says Doug Brown, managing partner at Black Book Research. Three-quarters of practices with three or fewer physicians can’t afford a consultant.

Small practices will experience more challenges

Initial MACRA requirements are fairly easy, Brown says, you simply attest to at least one performance improvement activity. But more than 80 percent of independent physicians in practices with four or more clinicians have not grasped how to align data with reporting measures.

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Many practices will turn to outsourcing as a last-minute fix

By the end of the second quarter of this year, the scramble to get programs on line will start to consume many practices. About 80 percent of surveyed organizations that have not developed their MACRA strategy are planning to select a turnkey software or outsourcer to catch up.

More practices will be sold

About 75 percent of remaining independent physicians are considering selling their practices to hospital or group practices to eliminate the administration burden and capital costs of MACRA.

Reimbursement changes lie ahead

In 2019, the first payment year, MIPS will take about $199 million from eligible clinicians below the performance threshold and redistribute those funds to providers above the performance threshold. Eventually, these redistributed dollars will represent 9 percent of Medicare physician payments.

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Physicians not aware of the impact of reputation

Some 54 percent of survey respondents are not aware that CMS will publish individual physician performance scores on the Physician Compare web site, with the scores also accessible by third-party rating systems such as Yelp, Angie’s List, Health Grades and Google.

Practices consider joining an ACO

Two out of three small practices are considering joining an ACO to avoid penalties for generally lower scores that result from a lack of infrastructure. More than 80 percent in rural areas are joining ACOs to avoid MIPS penalties.

MACRA propels cost and quality scrutiny

Some 54 percent of survey respondents are not aware that CMS will publish individual physician performance scores on the Physician Compare web site, with the scores also accessible by third-party rating systems such as Yelp, Angie’s List, Health Grades and Google.