New MACRA Preparedness Survey Illustrates Industry Concerns

The Medicare Access and CHIP Reauthorization Act, best known as MACRA, is some blend of enigma and nightmare for providers. A new study from NueMD, a cloud-based practice management software system, underscores the uncertainty surrounding the bill.

The survey had over 1,000 healthcare professional respondents, and yielded some not-encouraging, yet not-unexpected results. A full 50% responded that they were “not familiar” with MACRA, which began its reporting phase this year and will begin to assess its outcomes-based rewards and penalties in less than 18 months. Additionally, 56% reported not being sure if they were expected to participate this year.

Most of those who responded to the survey, 63%, worked in small practices of 1 to 3 providers. Professionals in those practices reported even higher rates of uncertainty about MACRA’s implications.

Majorities in both large (66%) and small (58%) practice employees reported that they were “not sure” how the changes would impact their practice’s financial wellbeing. Small practices were more likely to predict a negative impact than a positive one (25% to 7%), whereas large ones flipped that narrative, but with less of a gap (16% positive to 9% negative). Uncertainty also abounded around the impact it would have on time spent reporting, but those in practices large and small were more likely to believe that would increase than decrease.

NueMD refers to such industry murkiness as a “sobering lack of technological preparedness and resources,” for the transition to MACRA. A complex change in and of itself, worry seems to be growing among many in the industry that a lack of education may make the process even rockier.

The new survey from NueMD found that 49% of those asked had not even encountered information regarding MACRA. The deadline to begin reporting for Merit-based Incentive Payment System (MIPS) element is October 2nd, and practices that don’t send any 2017 data will face a negative 4% payment adjustment.

NueMD’s exploration did find a bit of silver lining. “We found out that professionals who have a firm grip on MACRA have a more positive outlook,” Caleb Clarke, director of marketing, said in a video that accompanied the press announcement. Of those reporting they were “very familiar” with the bill, 31% believed it would improve patient care, compared to 28% who said it would get worse, 21% who weren’t sure, and 20% who believed it would have no impact.

The survey results seem to line up with the buzz at recent industry meetings. Earlier this month in Philadelphia, Katherine Schneider, herself the CEO of an Accountable Care Organization, lamented that ““I have spent the last 2 years telling physicians that this is the biggest change in physician reimbursement that any of us have met in our lifetimes, and usually I am met with blank stares.” She indicated that direct communication between on-the-ground physicians and CMS officials tasked with enforcing the bill might be a way to close the understanding gap.