More than a third of health systems unprepared for MACRA: 8 findings

While most healthcare providers expect to participate in the Medicare Access and CHIP Reauthorization Act, only 35 percent have a strategy for doing so, according to a study published by Health Catalyst and Peer60.

For the study, researchers surveyed 187 healthcare professionals, including 37 CEOs and 94 other C-suite executives. Survey respondents came from organizations ranging from some of the nation's largest urban academic medical centers and integrated delivery networks to small, rural critical access facilities.

Here are eight survey findings.

1. Researchers asked survey respondents which MACRA-related activities "pose the greatest difficulties for healthcare organizations." Forty percent of survey respondents ranked "compiling metrics for regulatory reporting" as the biggest challenge. The next biggest challenge identified by survey respondents —18 percent— was the problem of "adjusting to greater coordination between providers and patients."

2. Only 35 percent of survey respondents said "we have a strategy and are well on our way to being ready" for upcoming MACRA reporting, based on 2017 charges, researchers said.

3. Still, most healthcare professionals expect to participate in MACRA, with only 5 percent of survey respondents planning to opt out of participating in the program.

4. Twenty-six percent of small- and medium-sized hospitals have a MACRA strategy for their employed providers but haven't made much progress implementing it, according to the survey. That compares to 33 percent of large hospitals and health systems.

5. In contrast, 33 percent of small- and medium-sized hospitals said they would participate in MACRA but currently have no strategy, compared to 24 percent of large hospitals and health systems, the survey found. Researchers said the most common reason for a lack of strategy is the organization was trying to figure out if providers could profit by participating in MACRA.

6. Two-thirds of the 73 small- and medium-sized hospital survey respondents that reported having a MACRA strategy expect their employed physicians will either receive a bonus or break even, despite whether they have made progress on their strategy, researchers said. Only one small hospital respondent said providers expected to receive a penalty, while nine said they were unsure.

7. Of the 45 survey respondents from large hospitals and health systems who said they have a MACRA strategy, 36 percent expected their affiliated physicians to earn a bonus while 31 percent said they expected physicians to break even, researchers said. Just one large hospital expected their physicians to receive a penalty, while seven were unsure whether they would benefit.

8. "Many health systems have hit the pause button on MACRA due to a combination of factors, including its complexity, the newness of the final rule and uncertainty about whether the new [president's] administration will make further changes. But those marching ahead are finding that compliance is likely to benefit their organization," researchers concluded. "The bottom line is that systems can choose which measures to report from their 2017 data, even if they haven't finalized their MACRA compliance plan, and it's likely worth their time."


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