- A recent survey by the American Medical Association (AMA) and KPMG found over 75 percent of physicians feel unprepared to meet MACRA requirements in 2017.
Published at the Eighth Annual Alternative Payment Model (APM) and Accountable Care Organization (ACO) Summit, the survey polled 1,000 practicing physicians regarding their views on MACRA and the Quality Payment Program (QPP).
Fewer than one in four reported feeling well prepared to meet the program’s requirements in 2017, and over half viewed MACRA’s requirements as overly burdensome.
MACRA is designed to push physicians toward embracing a value-based payment models in place of the volume-based reimbursement. This year marked a transition period for MACRA implementation and QPP with “pick your pace” options for physicians required to participate.
While 56 percent of physicians responding to the survey plan to participate in the Merit-based Incentive Payment System (MIPS) in 2017, 18 percent plan to qualify for the Advanced Alternative Payment Model (APM).
MIPS has variable incentive payments and penalties according to specific quality and efficiency measures. Advanced APM participants have the opportunity to receive a higher, more stable payment.
According to the survey, 51 percent of respondents involved in practice decision-making report being somewhat knowledgeable of MACRA and the QPP. However, only 8 percent describe themselves as deeply knowledgeable about the program and its requirements.
Furthermore, 90 percent stated the reporting requirements are between somewhat and very burdensome and cite the most significant challenge of the requirements as the time required to report performance.
Understanding the requirements was the second-most challenging aspect of MIPS reporting according to respondents, followed by how MIPS performance is scored, and finally the cost of accurately capturing and reporting performance.
Physicians without experience with existing value-based reporting systems and physicians working in smaller practices were significantly more likely to see requirements as very burdensome and feel less prepared for long-term financial success.
“This survey showed that about a third of respondents are unlikely to meet the basic standard of one patient, one measure, no penalty,” stated AMA President David O. Barbe, MD. “To help physicians meet that standard, the AMA developed and deployed resources to guide physicians toward compliance. Our resources include a step-by-step video on minimum reporting requirements to avoid a penalty in 2019 and a payment model evaluator that offers a brief assessment of where a practice stands.”
AMA and KPMG also jointly launched a Payment Model Evaluator designed to assist physicians with actionable insights regarding MACRA to assess the likelihood physicians will be eligible for MIPS or advanced APMs.
AMA intends to build on physicians’ experiences with this tool to further assist physicians in MACRA reporting.
“Aligning physician incentives with quality and other performance targets will lead to greater rewards for physicians and better healthcare for patients,” said National Leader of the Center for Healthcare Regulatory Insight at KPMG Lawrence Kocot. “While progress has been made in preparing physicians for the move from volume in the fee for service payment model to value in alternative payment models, it is important that we do even more to assist physicians with the transition.”
In keeping with provider concerns, CMS recently issued an unpublished version of a proposed rule simplifying the second year of QPP.
AMA released a public statement at that time commending the federal organization’s effort to offer physicians increased flexibility through these potential changes.
“CMS is proposing a number of policies to help physicians avoid penalties under the Quality Payment Program,” said Barbe. “In particular, it is suggesting several actions to assist small practices. The Administration showed it heard the concerns raised by the AMA on behalf of practicing physicians.”