Survey: Nearly 75% of providers are not ready for MACRA or need help

Dive Brief:

  • In a recent survey of more than 2,000 providers published by Healthcare Informatics, 43% said they need help with MACRA preparation, 30% said they are not at all prepared while 27% said they are ready to go.

  • Only 13% of respondents said they participate solely in value-based payment models and 35% said they participate in both fee-for-service and value-based models while 52% said they participate solely in fee-for-service models.

  • Asked whether strategies on value-based care have shifted since the November election, 47% said they are awaiting direction from the new administration, 33% said they have not made adjustments, and 20% said they were unsure.

Dive Insight:

MACRA is here. While CMS adjusted flexibility for the first year of participation in MACRA, many providers are unprepared for changes that will occur when it goes into full effect next year.

Smaller practices were more likely than larger provider organizations to be unprepared for MACRA. Among practices with 15 or fewer physicians, 80% reported that they were not at all prepared or needed help while 46% of practices with more than 100 physicians said that they were fully prepared.

The results revealed a bright spot. Most providers indicated they were at least somewhat prepared to report clinical data for the merit-based incentive payment system (MIPS). Only 19% said they were unprepared for MIPS reporting requirements compared with 47% who said they somewhat prepared and 19% who said they were very prepared.

CMS has committed $100 million over five years to help smaller practices cope with MACRA changes. However, it is not clear that will be enough. “It is critical that providers have a clear grasp and roadmap for where CMS is moving provider payments so they can start adjusting their workflows and begin acquiring the tools and resources they will need,” Arien Malec, vice president of data platform and acquisition tools at RelayHealth, told Healthcare Dive last September.

It is not clear whether the federal government will move forward with value-based reimbursement models as enthusiastically under President Donald Trump as it had under President Barack Obama. Members of the Trump administration have remained mostly quiet when it comes to value-based care or their comments have been underreported with media attention focusing on broader healthcare reform efforts.

There is some reason to believe the Trump administration will take a more tentative approach to value-based care. CMS announced recently that it would delay expansion of bundled payment initiatives, something recently appointed HHS Secretary Tom Price had publicly opposed during his time in Congress.

On the other hand, there is also reason to believe value-based care will be embraced by most lawmakers and regulators. MACRA passed with bipartisan support and Andy Slavitt, former acting administrator for CMS, recently expressed optimism for the future of value-based care. Aledade  CEO Farzad Mostashari wrote in Time yesterday showcasing MACRA's bipartisan benefits while looking forward the future of healthcare reform.

Providers still have time to prepare for MACRA before it goes into full effect next year, but time is running out. Over the next several years, payment models introduced by MACRA will gradually increase the risk and rewards tied to reimbursement. For the approximately one-half of providers who are not currently participating in value-based payment models, that is about to change

Filed Under: Health Law Hospital Administration Policy & Regulation Practice Management
Top image credit: David Goehring