Posted on June 8, 2017

NEHI IN THE NEWS: FIERCEHealthcare article - Physician leaders: 4 keys to MACRA success

by Joanne Finnegan | May 25, 2017


MACRA is changing healthcare with a new payment system that rewards participating Medicare doctors for the quality of outcomes they demonstrate.

The program will present challenges for physician practices, Anne Phelps, principal and U.S. healthcare regulatory leader at Deloitte, told FierceHealthcare. “MACRA is not merely a compliance law, but allows for physicians to think about alternative payment and delivery models that work best for them and help them achieve increased financial incentives in the future.”

At a summit earlier this year, healthcare leaders talked about how to make the Medicare Access and CHIP Reauthorization Act (MACRA) work.

Some 31 senior healthcare leaders were brought together by the Deloitte Center for Health Solutions and the Network for Excellence in Health Innovation (NEHI) to discuss the implementation of MACRA. The summit resulted in a report, “Rebuilding the foundation of healthcare under MACRA" that focused on the following four points:

  1. Technology and data are paramount. Organizations will need to use data to report on physicians’ performance, gain insight into what can be done differently and determine how to improve performance.
  2. Change will be hard, especially taking on risk. Many health system leaders said they want to take on more risk, but doing so is a challenge for their organizations as well as for individual clinicians. Many clinicians worry that they lack the tools and capabilities needed to change clinical models.
  3. Everyone should be at the table. MACRA’s fast-paced rollout and broad reach will require organizations across the healthcare system to work together. However, many leaders said they are hindered by organizational, competitive and regulatory barriers.
  4. Patients must be front and center. Patient outcomes and experience need to be a core focus of practices.

Phelps said MACRA is ultimately here to stay, despite the change of administration in Washington. “It is a bipartisan law that is generally supported by healthcare policy makers and stakeholders.

"Although the Trump administration is moving forward on MACRA, it is still a relatively new law and I expect that we will still be in a transition period for another year or so,” Phelps said. “I also expect rules may look different with Republicans holding the regulatory pen, but the Trump administration has communicated that they will be moving forward on MACRA.”

Many doctors are hoping new Health and Human Services Secretary Tom Price will make the Medicare payment system easier for them by reducing the reporting burden. Price, an orthopedic surgeon who has voiced worries about the impact on small and rural practices, will get his first chance to make a mark on MACRA with the release of a proposed Medicare rule, which is expected in the coming weeks.

While a survey last fall found over half of physicians either had not heard of MACRA or did not know much about it, Phelps said physicians are continuing to increase their awareness about the new payment system and what they need to do to comply.

“As they learn about the new rules and the ability to transition or 'pick your pace' as they enter into the new requirements of MACRA, many are taking advantage of the transitions given to them this year and thinking strategically about next steps,” she said.

To help practices ease into the MACRA payment system, the Centers for Medicare & Medicaid Services made 2017 a transition year, allowing practices to adjust the pace of their level of participation in the program.

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