I am frustrated and worried about what looks like a perfect storm approaching all physicians and hospitals. We are in the middle of transforming the American healthcare delivery system and shifting away from fee-for-service to value-based payment systems. As part of this transformation, Medicare is changing the way it pays physicians with the MACRA legislation.
I wrote about some of the complex and complicated issues facing American physicians in last month’s blog post. I have recently given MACRA updates to physician and hospital audiences in 10 different states, and I have been concerned that many are not up to speed on the new payment rules.
Just this week, Medicare announced that it is expanding its mandatory value-based payment models in 98 markets so that hospitals will be held accountable for the cost and quality of bypass surgery and myocardial infraction care. As part of this new program, it is expanding the definition of advanced payment models under the MACRA law that will allow physicians to avoid the transparent Merit Based Incentive Payment Systems track.
So why am I so worried? Before this week’s announcement. the physicians who knew about MACRA were already confused and anxious about how the new programs will affect how they will get paid.
Then this week as I was monitoring my Twitter stream to keep up on healthcare news, I saw two tweets that stopped me in my tracks. The Texas Medical Association announced the results of its TeleTown Hall where 69 percent of doctors stated they don’t know anything about MACRA and have taken no steps to prepare for the transition. And 57 percent said they needed more information about MACRA to get ready.
No surprise - 57% of Texas docs on our #MACRA TeleTown Hall Meeting say they still need more info to get ready for the change.
— Texas Medical Assoc. (@texmed) July 28, 2016
The other tweet was from Deloitte’s Center for Health Solutions, which reported a survey that found that 50 percent of American physicians have never heard of MACRA.
166 days. 23 weeks. Less than 6 months. This is how long the industry has to prepare for the first day of #MACRAhttps://t.co/2CrFeQcyOv
— Deloitte Health Care (@DeloitteHealth) July 25, 2016
The lack of awareness on the part of practicing physicians about MACRA, the constantly changing Medicare rules and the complexity of these new rules combine to create the conditions for a disaster. I call on everyone in the physician/hospital community to learn enough about the new payment programs to avoid this disaster. Please do let me know if I can help.
Kent Bottles, M.D., is a lecturer at the Thomas Jefferson University School of Population Health and chief medical officer of PYA Analytics.