It has been well-documented that many physicians are confused by value-based reimbursement models under the Quality Payment Program – but interestingly enough, little has been discussed about how prepared specialists are for this regulation. After all, specialists manage some of the nation’s sickest patients and costliest treatments and, therefore, may have the most to lose or gain under this reimbursement program.
To shed some light on how specialists are faring when it comes to MACRA preparedness, we conducted a survey at our June 2017 meeting. The survey’s respondents (representing the views of practices with 800 physicians i.e. 464 oncologists and 336 urologists) uncovered that a majority of specialists are unprepared to take the necessary steps needed to perform optimally, despite being aware of the clinical and financial opportunities that MACRA incentives could bring to their practices.
- 71% of specialists summarized their understanding of MACRA as, “I am learning but have a way to go,” but 100% of the respondents were not confident of succeeding under MACRA payment models based on their knowledge today;
- 56% of specialists intend to initiate practice transformation to better manage cost and quality by decreasing ER visits and hospital admissions;
- However, many specialists are adopting a “do-it-yourself” approach using existing resources and tools (40%) or have not started preparing (24%), which could negatively impact their prospects for success;
- 51% of specialists believe their practices’ EMR system is not prepared for value-based care (including alternate payment models like the Oncology Care Model and MIPS).
Taken together, the data shows that an increasing number of specialty physicians are realizing that the transition to more holistic management of patients in support of MACRA will require fundamental changes. The challenge is that few are taking the necessary actions to ensure success. To maximize clinical and financial returns under MACRA, these practices will need a combination of comprehensive technology designed for their needs, process improvements and dramatic cultural change with new skillsets such as care management and navigation at the core. See how Integra Connect helps specialty physicians via a suite of value-based care solutions.