8 Key Facts About MACRA

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October 25, 2016

In This Article

Effective Ways to Adapt

7. Refusing to Report Leads to Penalties

The way consultants describe it, physicians who have stayed away from reporting and plan to enter sometime in the future, when penalties are higher, will be sort of modern-day Rip Van Winkles. They'll be refugees from a different era who will have to learn the basics from the ground up, a process which will be protracted and painful.

It's unlikely that doctors will be able to wait out MACRA, in hopes that a new political regime will repeal it, because both parties in Congress supported the law. Even waiting for the final rule to come out in October seems pointless. Although some of the regulations may be softened, the thrust of the program is likely to be the same.

"If you want to continue to practice medicine, at some point you're going to have to bite the bullet and participate in these quality programs," Calamaro says.

One way to come in from the cold, Patrick suggests, is to choose just one program, such as the quality category, which accounts for 50% of the score for 2017. "That might be enough for many providers to at least stay neutral [in the composite score]."

8. Help Is Available

Medical societies have compiled detailed descriptions of MACRA for their members, but you may need direct assistance, says Bruce Hamory, MD, chief medical officer in the Health and Life Sciences Practice at Oliver Wyman, a management consulting firm based in New York City. "For practices to comply with these complicated requirements, they would need experts to come on site and help them through the process step by step," he says.

Small practices that lack support staff are most vulnerable, so MACRA is providing $20 million a year in funding to help solo practitioners and small groups of 15 clinicians or fewer. The money will go to a variety of training organizations, including regional extension centers that many physicians used to adapt to meaningful use.

Robert L. Wergin, MD, president of the American Academy of Family Physicians, says he used a regional extension center to get help with his own transition to healthcare IT. For a nominal fee, IT experts came to his practice to help him. "They gave me good advice," he recalls, helping him select an EHR vendor by pointing out the pluses and minuses of each one.

CMS is also offering assistance to practices that want to adapt to APMs in its Transforming Clinical Practice Initiative. The initiative will provide $10 million over the next 3 years to "leverage primary and specialist care transformation work and learning that will catalyze the adoption of APMs on a large scale," CMS' Andy Slavitt told[4] the Senate Finance Committee.


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