The lack of preparedness could hit physicians in the pocketbook, even amid new flexibility shown by CMS.
As a group, doctors are ill-prepared to meet the requirements of a law that will change the way they are paid, shows a survey of a thousand physicians by the American Medical Association and Big Four auditing firm KPMG.
That lack of preparedness could hit them in the pocketbook, even amid new flexibility shown by CMS in last week’s proposed changes that would delay mandatory reporting data for another year and reduced reporting burdens for small physician practices.
Physicians must choose one of two reimbursement tracks under the Medicare Access and CHIP Reauthorization Act (MACRA). One, known as the Merit-based Incentive Payment System, is where most physicians will start, but some will participate in approved Advanced Payment Models (APMs) that will reward physicians with as much as 5% annual payment bonuses in return for taking more upside and downside risk based on value measures.
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In either scenario, physicians rate themselves as less prepared than they should be, with half calling MACRA requirements “very” burdensome, according to the survey.
More than 56% of those surveyed still planned to participate in the MIPS program in 2017, while 18% are expected to quality for higher and more stable payment as an APM participant.
Many physicians, 90% of whom felt the reporting requirements were “somewhat” or “very” burdensome, felt that the time required to report performance was the most significant challenge they face with MACRA, while understanding the requirements, how MIPS performance is scored, and the cost required to accurately capture and report performance were also noted as challenges.
AMA president David O. Barbe, MD, said that physicians needed to be more proactive about accessing resources that would guide them toward minimum compliance levels.
“This survey showed that about a third of respondents are unlikely to meet the basic standard of one patient, one measure, no penalty,” he said in a press release. “In just 10 steps, physicians can successfully meet the standard under MACRA.”
The survey was conducted prior to CMS’s changes to the 2018 proposed rule, which would exempt markedly more, mostly smaller, physician practices, from MACRA’s reporting requirements.
Philip Betbeze is the senior leadership editor at HealthLeaders.