Specialty practices way behind on MACRA readiness, survey shows

Survey shows few are making key investments, changes required for move to value-based care.
By Beth Jones Sanborn
12:30 PM
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MACRA readiness

A new survey from technology provider Integra Connect has found that a majority of specialty physicians have yet to make the necessary organizational, IT, or service investments to achieve success under MACRA success.

Integra Connect, which provides services for value-based specialty care, conducted the survey among attendees of the company’s June meeting in Atlanta. The respondents’ practices represented about 800 physicians, 58 percent of which were from oncology practices and 42 percent were from urology practices.

For starters, 100 percent of survey respondents admitted they have not yet fully grasped MACRA's impact on their practices. The most common description – selected by 71 percent of respondents – was, “I am learning but have a way to go.”

MACRA, officially the Medicare Access and CHIP Reauthorization Act, was signed in 2015 to convert physician reimbursement to value-based healthcare system based on performance, replacing the fee-for-service model.

But while 56 percent said their goal is to deliver cost savings under MACRA “through practice transformation to avoid unnecessary hospital stays and ER use,” roughly two-thirds are either not prepared at all to do so or are taking a "do-it-yourself" approach, which will likely limit their existing resources and tools.

When drilling down into specific challenges, respondents listed the three top barriers to succeeding in MACRA’s Merit-based Incentive Payment System: having the right people/skills, understanding the requirements, and making the cultural shift required to assume accountability for patients.

However, specialty practices acknowledged that investments in consulting services, new care coordination resources, and new EHRs could help conquer those challenges as. In fact, 51 percent of respondents said they don’t believe their EHR can handle value-based care, including alternative payment models like the Oncology Care Model, MIPS, and other bundled-payment programs.

When it comes to EHRs and other technological upgrades, money is an issue, as 62 percent of respondents either don't know how, or have no plans, to fund these investments, the survey found.

"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,” Charles Saunders, CEO of Integra Connect, said in a statement.

Bernie Monegain contributed to this report.

Twitter: @BethJSanborn
Email the writer: beth.sandborn@himssmedia.com