In addition to gauging awareness of MACRA, the nationally representative survey of 600 physicians asked their perspectives on the law's implications and their attitudes toward and readiness for change – change that will come in the form of new care models, new payment models and new delivery models.
"The changes associated with MACRA are fast approaching," said Anne Phelps, principal, Deloitte & Touche LLP, and US health care regulatory leader. "The first performance reporting period begins January 1, 2017. The fact that so many physicians and clinicians still haven't heard of the law means they'll have a lot of work to do over the next five months, including evaluating current payment processes and understanding how physicians are organized within their hospitals or practices."
Just 50 percent of non-pediatric physicians surveyed have heard of MACRA, for which the final rule is expected from the US Centers for Medicare and Medicaid Services (CMS) this fall. Additionally, more self-employed physicians and those surveyed in independently-owned medical practices (21 percent) – as compared to surveyed physicians employed by hospitals, health systems, or medical groups owned by them (9 percent) – report that they are somewhat familiar with the law. The survey also found that physicians with a high share of Medicare payments are just as unaware of MACRA as others.
New incentives established by MACRA also will likely drive payment and delivery reform efforts across other payers. The law will allow clinicians to develop new care models and encourages new collaborations between plans and hospitals, but, according to the survey, nearly 8 in 10 physicians prefer traditional fee-for-service or salary as compensation. This means many physicians will likely have to adjust their current approach and practice management based upon MACRA's specifications.
"MACRA is what can make value-based care real," said Mitch Morris, principal, Deloitte Consulting LLP, and leader for the health care industry at Deloitte. "It's exciting but also challenging. For example, while the survey found the majority of physicians believe that the performance of the US health care system can be improved by measuring care outcomes and processes and measuring resource utilization and costs, the survey also found most physicians believe performance reporting to be burdensome and don't support tying compensation to quality. These physicians will likely have to change aspects of their practices to meet new reporting requirements."
Perhaps one of the biggest changes physicians will have to consider is the need to bear increased financial risk. The survey found that physicians recognize this need, under MACRA and in general. With that in mind, most physicians surveyed expect increased physician consolidation, due to general financial pressures. Many physicians surveyed (58 percent) said they would opt to be part of a larger organization to diminish individual physician risk and/or to have access to a full spectrum of resources and capabilities. Additionally, 80 percent of physicians surveyed expect MACRA to drive physicians to join larger organizations or networks.
More information on MACRA can be found at www.deloitte.com/us/macra or by contacting Deloitte's MACRA team at email@example.com.
About the Deloitte Center for Health Solutions
The source for health care insights: The Deloitte Center for Health Solutions (DCHS) is the research division of Deloitte LLP's life sciences and health care practice. The goal of DCHS is to inform stakeholders across the health care system about emerging trends, challenges and opportunities. Using primary research, rigorous analysis and providing unique perspectives, DCHS seeks to be a trusted source for relevant, timely and reliable insights.
As used in this document, "Deloitte" means Deloitte LLP and its subsidiaries. Please see www.deloitte.com/us/about for a detailed description of the legal structure of Deloitte LLP and its subsidiaries. Certain services may not be available to attest clients under the rules and regulations of public accounting.
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