Survey finds half of physicians have never heard of MACRA

This may be one more reason for the government to delay the start date for the Medicare Access and CHIP Authorization Act of 2015  (MACRA): a new survey finds half of physicians aren’t even aware the Medicare payment system is about to change.

Centers for Medicare & Medicaid Services  Acting Administrator Andrew Slavitt made some major news Wednesday when he told members of a senate committee the agency is considering a delay in the January 1 start date for MACRA. He got another reason to do just that with the release of a survey that found half of physicians have never heard of MACRA, a law that will fundamentally change how physicians are reimbursed under Medicare.

In a survey of 600 physicians, the Deloitte Center for Health Solutions, found while many doctors have never heard of MACRA, most physicians will have to change aspects of their practice to meet the law’s requirements and do well under its payment system. If CMS doesn’t delay the January 1 start date for the first reporting period, “the fact that so many physicians and clinicians still haven't heard of the law means they'll have a lot of work to do over the next five months,” said Anne Phelps, principal at Deloitte & Touche LLP, in a survey announcement.

Concerns that many physicians, especially those in small and rural practices, are not ready to implement MACRA changes is a major reason why CMS may consider a delay, Slavitt told members of the U.S. Senate Finance Committee yesterday.

The American Medical Association, which is among many physician organizations urging CMS to delay MACRA, was heartened by Slavitt’s “consideration of options that include an alternative start date, shorter reporting periods and finding other ways for physicians to get experience with the program in the early stages of implementation," said its President Andrew W. Gurman, M.D., in an announcement. “Successful implementation will require flexibility, and indications are that CMS intends to work toward the goal of giving physicians a fair shot in adjusting to this new policy framework.”

MACRA will give physicians two payment options: the Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APM). In a study by the Brookings Institution, researchers said physicians who are consistently high performers would earn more in Medicare reimbursements under MIPS than with other alternative payment models. In theory, even physicians in an APM who are confident they will score well on quality and value metrics might be better off being judged under MIPS, the report said.

But with only six months to go before the possible start date when physician performance will have an impact on Medicare payments, “most [physicians] are confused about how best to navigate the various programs given the complexity of the rules and options,” the researchers concluded. CMS is currently reviewing more than 3,800 comments on its proposed rule and is expected to release a final rule this fall.

- read a survey announcement
- find the survey results
- check out the AMA announcement
- read the Brookings Institute report