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Survey Finds Small Physician Groups Need Help with MACRA Implementation

April 05, 2017

A new survey commissioned by Healthcare Informatics shows that, despite the slower pacing of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), many small physician groups are not fully prepared for its implementation during 2017.

The program—which transitions providers from Medicare payments based on volume to payments based on value—will have a significant impact on Pennsylvania hospitals and the physicians they partner with to provide care.

This survey asked physicians if they are “ready to go” to meet the core requirements under MACRA. Of the 2,045 phsyicains who responded, the following percent reported that they were ready:

  • 20 percent (practices with 15 or less physicians)
  • 28 percent (practices with 16 to 50 physicians)
  • 46 percent (practices with 100 or more physicians)

The Centers for Medicare & Medicaid Services (CMS) has recognized the needs of smaller practices and has allocated $20 million yearly for preparing small practices and physicians in rural and underserved communities. In addition, physicians with less than 100 Medicare patients, or less than $30,000 in Part B charges are excluded from MACRA.

The survey also asked about the transition from fee-for-service (FFS) to value-based payment (VBP) models. Only 13 percent of the respondents were in VBP-only agreements, while 52 percent were still in a FFS-only environment. Even though MACRA is not part of the Affordable Care Act (ACA), the surveyors did ask about the impact of a possible repeal of the ACA on their future payment strategy. Almost half of respondents (47%) are adopting a “wait and see” strategy as President Trump and the Republican-controlled legislature consider how to roll back the ACA. Unfortunately, the published survey did not break down these results by size of practices.

CMS provided educational programs for Pennsylvania physicians in 2016. HAP also provided education on 2016 Medicare Quality Reporting (slides, audio). Despite these efforts, it appears that physicians in smaller groups may still be at risk for future reduced revenues while caring for Medicare patients due to their lack of preparation.

For more information, contact HAP’s Kate Slatt, senior director, health care finance policy.

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