Health IT Pulse

May 10 2017   12:59PM GMT

The top four MACRA and MIPS trends challenging providers

Kristen Lee Kristen Lee Profile: Kristen Lee

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MIPS

From February through April 2017, Black Book Research crowdsource-surveyed 8,845 physician practices about the transition to the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 which aims to transition healthcare from fee-for-service-reimbursement to value-based reimbursement.

The survey found this transition is proving to be tricky for physician practices.

Here are the top four health IT trends that could prove challenging to providers during this transition:

1) Physician practices unaware of certain MACRA and MIPS details

Many of the survey respondents were unaware of certain aspects of MACRA:

  • 54% of respondents were unaware that the Centers for Medicare and Medicaid Services (CMS) will publish data on their Physician Compare website. This data will also be accessible via Yelp, Angie’s list, Health Grades and Google.
  • 69% of the surveyed physician practice managers are aware they need to report on six quality measures; however, only 22% are aware that they had the option of choosing the metrics they believe represent the strengths of the practice.
  • 94% of respondents were unaware or unsure of how to predict their Merit-Based Incentive Payment System (MIPS) — a new program that is part of MACRA that measures eligible professionals on quality, resource use, clinical practice improvement and meaningful use of certified EHR technology — scores for 2017.

2) The market for MIPS technology is booming

Of  physician practices with three or more clinicians that responded to the survey, 77% seek to buy MIPS Compliance Technology Solutions by Q4. However, 92% of respondents were not aware of any branded technologies that support MACRA and MIPS measures for 2017 reporting other than their EHR.

Interestingly, the primary reason for provider organizations to acquire MIPS technology was not quality measurements but because they were having trouble deciphering their MACRA earning potential, 89% of respondents said.

“Given the magnitude of the changes, the hunt is on for the best MIPS incentive enablement resources,” said Doug Brown, managing partner at Black Book Research, in a press release. “Finding one stop solutions shop for MIPS support is becoming easier with quality measure monitoring dashboards and enterprise analytics vendors.”

3) Ambulatory EHR Optimization sparked by MACRA and MIPS

The eight largest EHR systems include Cerner, Epic, Allscripts, eClinicalWorks, NextGen, athenahealth, Practice Fusion, and GE Healthcare, according to the survey. Of the physician practices surveyed, 72% said they are using EHR products not considered as part of those top eight EHRs and stated that they were not working with their EHR vendor to make sure they are prepared for MIPS measures and can properly report data.

“The replacement market is heavily leaning to these largest 8 EHRs from small EHR vendors and expected to increase through 2018 as some providers had previously invested in EHRs that do not acclimate to agile change at scale like MACRA demands,” Brown said in the press release. “EHR companies are not required by MACRA to update their technology so providers are ill-equipped should the practice stick with their uncertified EHR.”

4) Physician practices struggle to align data

The survey found that 81% of respondents said they have not grasped how to align data with reporting measures.

“Seemingly, the MACRA requirements appear fairly easy to meet, you simply attest to at least one performance improvement activity. However, the reality will be significantly more difficult as smaller practices in particular begin preparing for risk,” Brown said in the press release.

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