From meaningful use to the Medicare Access and CHIP Reauthorization Act (MACRA), the headlines in healthcare for the foreseeable future will surround this latest payment carrot-and-stick regulation.
Like meaningful use, which is now regular vernacular in healthcare, the potentially disruptive MACRA will soon be just as popular of an expression for those in every aspect of the care protocols. Right now, not so much.
Deloitte’s 2016 Survey of U.S. Physicians suggests that only about 50 percent of practicing physicians have heard of MACRA, but there’s still plenty of time, relatively, for physicians to become familiar with the regulation since the final rule is not slated for release until Nov. 1. But for now, mum is the word.
The quick turnaround for the enacted regulation comes in January 2017 when the payment reform comes to life and begins to impact physicians and, potentially, their pocketbooks. So, while there’s some time for physicians and their staff to come to understand what MACRA does, there’s not much time to understand how this is going to affect them in the long term.
"Regardless of their awareness level, most physicians surveyed would have to change aspects of their practice to meet the law’s requirements and to do well under its incentives," the Deloitte report noted.
The Deloitte survey was based on responses from 600 U.S. physicians representative of the American Medical Association file in terms of years in practice, gender, geography, practice type and specialty, according to Healthcare Dive. "A subsample of 523 physicians with non-pediatric specialties was specifically asked about MACRA because it targets Medicare payments," the news site notes.
The survey assesses physicians’ awareness of the law and their preparedness (or lack of preparedness) for it. Thirty-two percent of non-pediatric physicians only recognized the MACRA name. According to Modern Healthcare, independent physicians were more aware of MACRA than employed physicians, "which is likely because they are more involved in their business management."
Perhaps as eye-opening is that 80 percent all the physicians surveyed said they preferred traditional fee-for-service or salary for their compensation, which is somewhat pointless, since those payment models are likely on life support, especially given MACRA.
MACRA works with two payment tracks -- clinicians in advanced alternative payment models can earn bonuses annually of 5 percent, while the majority of physicians will participate in the Merit-based Incentive Payment System. Thus, physicians can earn plus or minus 4 percent of reimbursement in 2019, 5 percent in 2020, 7 percent in 2021 and 9 percent in 2022.
However, unfortunately, MACRA projections show physicians in groups of less than 10 physicians suffering financial penalties.
Almost 90 percent of solo practitioners said they expect their reimbursement to fall, but MACRA numbers show physicians in groups of 25 to 99 can expect to see their reimbursement rise. Physicians in groups of more than 100 are anticipated to get a reimbursement from MACRA.
