Less than four months. As we head into September, that's how long the health care industry has to prepare for the first day of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). And for many, it could be an uphill battle: According to Deloitte's 2016 Survey of US Physicians, half of surveyed physicians have never heard of MACRA, and most physicians would have to change aspects of their practice to meet the law's requirements and do well under its incentives.
Some physicians may think of MACRA simply as “the law that repealed the sustainable growth rate (SGR),” leading them to believe that they can move on and forget about the annual doc fix debate they had grown so accustomed to. Others may view it as a repeat of ICD-10 implementation – where the deadline will inevitably change before it is finalized
But MACRA is more than a Medicare payment law or a fix to the SGR debate. And it is here to stay. The announcement from the Centers for Medicare & Medicaid Services (CMS) on Thursday, September 8, 2016 states that the first performance period will still begin on January 1, 2017.
MACRA is a transformative law that, with bipartisan support from both sides of the aisle in Congress, is on track to fundamentally change how physicians and other clinicians are reimbursed under the Medicare Physician Fee Schedule (PFS). It will also drive major health care payment and delivery system reform for clinicians, health systems, Medicare, and other government and commercial payers for years into the future.
Deloitte's 2016 Survey of US Physicians sought to quantify where physicians – the primary subjects of this transformation – are in their familiarity and understanding of the law and how prepared they are to transform with it. The results suggest that many physicians will have a lot of work to do over the next few months to prepare for January 1, 2017. Indeed, half the non-pediatric physicians we surveyed say they had never heard of MACRA, and less than one-third say they recognize the name but are not familiar with the requirements.
More self-employed physicians and physicians in independently owned medical practices (21 percent) report that they are somewhat familiar with the law than physicians employed by hospitals, health systems, or medical groups owned by them (9 percent). But, physicians with a high share of Medicare payments tend to be just as unaware of MACRA as others.
We also found that while most physicians surveyed agree that health care system performance can be improved by measuring care outcomes and processes and measuring resource utilization and costs, most physicians also believe that performance reporting is burdensome. Few support tying compensation to quality and most prefer traditional compensation models, such as fee-for-service and salary over value-based payment models.
The good news is that, according to the survey, as physicians gain more experience with value-based care efforts, they tend to be more prone to understanding its identified benefits and are more open to its possible improvements to the delivery system. The industry as a whole has a great deal of work ahead to prepare for MACRA and its impact. At this point, maintaining the status quo is not an option.
Read more on physician readiness for MACRA and the timeline for implementation at: www.deloitte.com/us/macra.