A survey of 800 oncologists and urologists found that they have significant concerns about their practices’ preparations to shift to new payment incentives that will be used under emerging federal payment programs.

About seven in 10 of the specialists say they are not ready to make the shift to payments under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The law creates two payment pathways for physicians—alternative payment models (APMs) and the Merit-based Incentive Payment System (MIPS).

MACRA is designed to improve the quality of care while cutting costs through value-based reimbursement. Provisions of the program will incorporate provisions of the meaningful use program for electronic health records.

A meeting to discuss clinical and operational issues that was convened by Integra Connect, which develops data management platforms for specialists, included a survey on how the clinicians viewed MACRA. All respondents say they have not yet fully grasped the law’s impact on their practices, and 71 percent indicating they are still in the learning curve and have a ways to go.

“The data show 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,” says Charles Saunders, MD, CEO at Integra Connect. “The challenge is that few are taking the necessary actions to ensure success.”

Also See: Regional extension centers help providers prep for MACRA

More than half of respondents are working toward delivering cost savings through practice transformation to avoid unnecessary hospitalizations and use of hospital emergency departments.

But at the same time, 24 percent indicated they are not prepared at all for MACRA, and another 40 percent are working toward compliance but using only existing resources and tools to manage population health and deliver cost and quality improvements.

Clinicians identified three core barriers to being successful with MIPS: having the right people with the right skills, understanding requirements and developing cultural changes necessary to assume accountability for patients.

However, nearly two-thirds of survey respondents said they either don’t know how to overcome these barriers or have no plans to fund upfront investments to succeed with MIPS. Further, half of respondents believe their EHR is not ready to handle value-based care and bundled payments.

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