Independent physicians are struggling with the complexities and aggressive timing of the Centers for Medicare & Medicaid Services (CMS) rule finalizing the Medicare Access and CHIP Reauthorization Act (MACRA) Quality Payment Program, according to a survey conducted by software-as-a-service technology company Kareo (Irvine, Ca.).
The company surveyed 170 independent physicians and their staff after CMS released the final MACRA rule in October and the survey results indicate that most practices expect to participate, but they are still uncertain about what the requirements are or how the program will impact revenue.
About eight out of 10 independent physicians reported they are uncertain what MACRA’s QPP will require of their practice, however, despite this uncertainty, most of these same physicians (85 percent) expect to participate in it to the best of their ability. With payment adjustments potentially reaching plus or minus nine percent by 2022, this survey findings indicate that most practices intend to do what is necessary to avoid an adjustment and/or try to get an incentive.
When asked if they understood what MACRA requires of their practice, 41 percent said they were not sure and 43 percent said they disagreed or strongly disagreed. Only four percent said they strongly agreed that they knew what MACRA required of them.
Similar results were seen when asked about the impact on revenue, as 63 percent of independent physicians weren’t sure if MACRA would reduce reimbursement. When asked about whether MACRA would increase reporting burdens, more than 60 percent said the reporting requirements would increase for their practice.
The proposed rule was announced in the spring of 2016, followed by a comment period. Industry groups, providers, and vendors responded with feedback, some of which was incorporated into the rule. The final rule came out on October 14, and it stated that the reporting period would begin on January 1, 2017 for those who want to fully participate and try to get a positive payment adjustment. That left just over two months for eligible clinicians and vendors to get ready.
“At Kareo, we felt that it was important to understand how prepared our customers really were to begin participating in the Merit-Based Incentive Payment System (MIPS), which is the QPP path most of them will follow,” Dan Rodrigues, founder and CEO of Kareo, said in a statement. “Our survey highlighted that independent practices want to comply but they are struggling with the complexity and aggressive timing of the rule.”
Rodrigues added, “Independent practitioners want to stay independent so they want to participate in programs like MACRA and avoid possible penalties. But they need help to do it. The addition of the Pick Your Pace options in the final rule is a step in the right direction.”