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Physicians Foresee Major Burden in Quality Payment Program

A recent MGMA survey found a vast majority of physician physicians perceive the Quality Payment Program to be highly burdensome.

Quality Payment Program

Source: Thinkstock

By Kate Monica

- A recent survey from the Medical Group Management Association (MGMA) found 82 percent of responding physicians view the Quality Payment Program (QPP) as very or extremely burdensome.

The survey featured responses from physicians at 750 group practices — integrated delivery systems, medical school faculty practice plans and academic clinical science departments, managed services organizations, physician practice management companies, independent practice associations, and others.

Independent medical practices and groups with between six and twenty physicians represented the greatest number of respondents. Practice specialties ranged from multispecialty healthcare organizations with primary and specialty care to family practices.

While MACRA was designed to be less burdensome than previous federal reporting requirements such as under the EHR Incentive Programs, only 1 percent of respondents viewed QPP as not burdensome.

Eighty-four percent of respondents are participating in the Merit-Based Incentive Payment System (MIPS), one of the two tracks of QPP.

According to respondents, this burden has a significant impact on care delivery: 64 percent of surveyed physicians agreed that a reduction in Medicare’s regulatory complexity would allow their practices to reallocate resources toward patient care.

Regulatory burden extends beyond consuming a physician’s time during the workday to the practice’s bottom line.

Eighty-seven percent of respondents reported their practice either directly or indirectly spent over $10,000 per full-time physician in 2016 on ensuring they complied with new and existing federal regulations.

Furthermore, 14 percent of respondents reported spending more than $100,000 per full-time physician on meeting federal quality reporting requirements.

These expenses went toward staff training surrounding regulations, health IT implementation and upgrade costs, consulting and attorney fees, and loss of physician productivity.

In addition to administrative burden associated with QPP, 74 percent of respondents also noted a significant burden stemming from a lack of electronic attachments for claims and prior authorizations.

Lack of EHR interoperability was the fourth-highest burdensome regulatory issue, with 68 percent of respondents agreeing the problem has proved very or extremely burdensome for providers.

Despite an overall negative perspective among physicians regarding QPP, nearly half of respondents intend to fully participate in MIPS in the 2017 transition year.

Forty-one percent of physicians stated they intend to report the full set of MIPS data this year to aim for a positive payment adjustment in the hopes of qualifying for an exceptional performance bonus in 2019.

Twenty percent stated intentions to report the minimum amount of information to avoid a penalty in 2019, and only 8 percent reported being unsure about their projected pace for 2017.

MGMA also gained insight into the level of concern providers currently have regarding the ability of their practices to participate fully in MIPS.

Eighty percent of responding providers reported being concerned about their practice’s ability to successfully participate based on the program’s clinical relevance to patient care.  Furthermore, nearly three-fourths of providers anticipated struggling to participate due to overall implementation costs.

According to physicians, the fourth likeliest barrier to entry for successful MIPS participation is the lack of clear program guidance.

On top of apprehension among respondents regarding reporting requirements, most providers also do not see MIPS as especially useful to their practices. Seventy-three percent of respondents stated the government program does not support their practice’s clinical quality priorities.

A propos of a topic being hotly debated of late, a majority of providers report a fair amount of concern regarding potential problems stemming from federally-mandated EHR certification requirement.

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