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MACRA Burnout – MACRA Monday

Posted on May 1, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program.

It’s May 2017 and I’m already burnt out of MACRA. Does anyone else feel this way? The MACRA program has just gotten started and I’m already pretty sick and tired of talking about the details. I can only imagine how a doctor feels at this point. It feels a little bit like groundhog day doesn’t it?

I’m sure much of what contributes to this is the layers and layers of government requirements that we’ve had to go through over the past 5-6 years. It started with meaningful use and PQRS and then we realized there were multiple stages of meaningful use. We’ve been through stage 1 and stage 2. Of course, related to that is all the EHR certification regulation. Then, ICD-10 hit us upside the head. We worked through it, but it wasn’t fun and didn’t add much value to our patients or our organizations. Now we’re hit by MACRA. Aren’t we all just a little tired of these regulations?

Don’t get me wrong. Healthcare is a highly regulated industry, so this is the norm. Plus, I’m not saying that practices should just shun MACRA. Most practices I know need to at least avoid the penalties. So, they’ll have to participate, but I don’t know a single doctor that’s excited about the benefits of any piece of the MACRA legislation. That should tell us something and we should listen.

Think about what an achievement that is by MACRA. Doctors aren’t excited about any of it. It’s actually kind of embarrassing to think about. If you are a doctor that’s excited about some piece of MACRA and especially MIPS, I’d love to hear about it. How is any of it going to improve care, lower costs, or improve productivity? I’ll be waiting in the comments, but I certainly won’t be holding my breathe.

How sad that millions of dollars and millions of hours are going to be wasted on a legislation that isn’t too hard, but also doesn’t add value. That’s a travesty and I don’t see it changing.

I’m trying to think what would reinvigorate organizations. Is there a legislation that doctors would get excited about? That’s a hard thing to crack, but the best I could do is interoperability. What if we scraped all of MACRA and just focused on penalizing organizations that aren’t sharing data with each other.

Even this change would leave a lot of people wondering the exact value. However, there’s a pretty solid case to be made that exchanging healthcare data could improve care and lower costs. Those are things that people can get behind.

All of this said, I’m not expecting any changes. MACRA is here to stay and EHR vendors and healthcare organizations are going to have to grind it out and participate. However, that doesn’t make the MACRA burnout any less poignant.

Be sure to check out all of our MACRA Monday blog posts where we dive into the details of the MACRA Quality Payment Program.

MACRA Stats – MACRA Monday

Posted on April 17, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program.

I love a good stat. I realize that you can make stats tell you whatever you want. However, if you look at them with a critical eye, you can learn something about both the organization producing the stat and the population that the stat represents.

It’s no surprise that I found these MACRA stats shared by David Chou to be of great interest and a perfect MACRA Monday discussion.

The stat that stands out to me is the 51% of physicians who reported that they weren’t getting paid on a performance basis or that their compensation had a very small performance based piece to it. For those of us following the cutting edge of what’s happening in the world of healthcare, it’s sometimes important to remember that while the shift to value based reimbursement is happening, it still has a long ways to go.

I found David Chou’s tweet with these stats interesting when he said “Most physicians prefer the old model of payment vs MACRA.” I would look at these stats a bit differently than David.

I would suggest that these stats say that doctors prefer reimbursement models they understand and ones that pay them well. This is proven out in the stat that 71% of physicians surveyed would participate in value-based payment models if offered financial incentives to do so. It’s not really a shocking insight that doctors are happy to shift models if there are financial incentives to do so.

The challenge is that most doctors don’t think that a value based reimbursement model is going to pay them more for the work they do. They’re probably right. This explains why nearly 8 in 10 physicians surveyed prefer fee-for-service or salary for their compensation. If a new model came along that would pay them more than their current fee for service model, then they’d happily switch models.

Sometimes we make things too complicated. Physicians just want to be paid well for the work they do. Sounds like all of us no? The concern for most physicians is that these models are unlikely to pay them more. In fact, it’s quite possible they’ll pay them less or at least pay them the same for more work.

I haven’t seen any plan or projections to pay doctors more. In fact, the rhetoric in society is that we pay too much for healthcare (which is true). As a society, we all agree that we should be paying less for healthcare. However, as a healthcare provider or healthcare organization the idea of paying less for healthcare translates to getting paid less. Who’s going to take the hit when it comes to getting paid less? Providers? Hospitals? Pharma? Med device companies? Health IT Companies?

Could value based reimbursement models theoretically cost less and pay all of these stakeholders the same amount of money because patients were healthier? Works great in theory, but looking at the past history of these programs tells another story. So, it’s no wonder that most doctors would happily stay in the fee-for-service reimbursement world they know vs moving to value based reimbursement models.

Be sure to check out all of our MACRA Monday blog posts where we dive into the details of the MACRA Quality Payment Program.