4 Takeaways from a MACRA Panel

On Tuesday, September 20, I had the privilege of serving on a panel sponsored by Corus 360 devoted to issues surrounding the Medicare Access and CHIP Reauthorization Act (MACRA).  Some have called MACRA the most significant change in the way Medicare pays physicians since the program began 50 years ago.  There are some up sides, but also significant penalties for non-compliance.  Unfortunately, many physicians have only limited knowledge about this very significant piece of legislation.  Hence the Corus 360 event.

There were four of us on the panel, and I wanted to share comments from each person.

Dee Cantrell, RN, BSN, MS, FHIMSS (Former hospital CIO and Founder, CIO Consultancy) – When asked about the key to successful MACRA implementation, she didn’t hesitate to point to getting the right governance structure in place.  Since MACRA will affect so many aspects of physician’s funding and operation, its ripple effects will be felt broadly throughout hospital and physician organizations, and it’s important to get the right people fully engaged.

Domenic H. Mack, MD, MBA (Director, National Center for Primary Care) offered what was my favorite new insight of the morning.  He stated that in the old days, he used to take patient notes and provide documentation to track what he had done for his patients and help him remember what future action was needed.  Nowadays, however, physicians document for someone else.  And they hate it.

Glenn E. Pearson, FACHE (that’s me!) – I observed that physicians are putting themselves in one of three buckets.  They will either: 

·         See past the hassle, expense, inconvenience, and confusion of MACRA, and recognize how it can ultimately improve care coordination and patient outcomes.  This group will embrace MACRA, albeit reluctantly,

·         Detest it and comply only to the minimal level so they can “check the box,”

·         Or, consider MACRA the “last straw,” ride out the final few years of their careers (if they have been in practice for many years) before the penalties get too severe, and then gladly retire.

Liz Hansen (Senior Advisor to the Georgia Health Information Technology Extension Center) jumped right in after my “three buckets” comment and stated that hospitals and physician groups had better get a pretty big bucket for group two since that it where the vast majority of physicians are.  In her work helping physician groups, she basically tells them to “get over it” and recognize that MACRA is a reality whether they like it or not.  They can complain all they like, but they should “burn their boats” behind them, leaving no mechanism for retreat, and recognize that the past is gone and isn’t coming back.  She also observed that physicians really don’t care that much about ROI, to which I commented that they do care about their own paychecks.  And that’s an important point to remind them of.

 

So it was a good meeting, and there were many more other terrific insights!  Many thanks to Corus365 and my fellow panelists.