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To clarify MACRA's impact, we surveyed over 1,000 providers, administrators, and medical office staff. We hoped to:

  • Gauge MACRA familiarity
  • Focus on attitudes toward MACRA
  • Measure the level of stress caused by the transition

MACRA? Hey, what did you call me?

Take it from this ancient proverb: There’s two types of health care professionals - those who doubt MACRA and those who aren’t sure.

OK. We made that up, but what we can’t make up is that half of the healthcare professionals who took our survey say they’re not at all familiar with MACRA.

Majority Don’t feel Familiar with MACRA

“I’m not sure” was the most common answer we got to every question in our survey.

Only 9% consider themselves to be very familiar with MACRA and reporting started this year.

Are you familiar with MACRA? 50%(464) Not at all, 41%(383) Somewhat, 9%(90) Very. Total Responses:937

We’re not only dealing with an industry-wide lack of preparedness, but a big ol’ lack of basic familiarity.

Eligibility is Widely Unknown

At the time of our survey, 56% of participants did not know whether they qualify to participate in MACRA’s Quality Payment Program (QPP).

However, during the survey period, CMS issued notices to physicians by mail if they’re expected participate in 2017. So we're hopeful those numbers have since improved.

Are You Eligible?
MACRA Eligibility is calculated again December 2017. Avoid a negative payment adjustment by checking your status now: https://qpp.cms.gov/


MACRA Information Not Easy to Find

We asked survey participants if they had ever encountered information on MACRA, including articles, webinars, and infographics. Most said no.

In fact, 49% said have not encountered any information on MACRA.

Have You Encountered and Information on MACRA? No - 49%, Yes (Wasn't Actively Seeking It) - 30%, Yes (Actively Seeking It - 21%. Total Responses:940

Note: CMS has deemed 2017 as a “Transition Year” for MACRA, which means it’s only going to get more difficult. If you’re one of many who hasn't encountered info on MACRA, start now.

MACRA Knowledge is Empowering

According to our survey, the biggest influence on how physicians feel about MACRA is their familiarity with it.

When we asked participants how they expect MACRA to impact their practice over the next three years, 63% responded - I’m not sure. Only 9% feel it will have a positive impact.

How Do You Think MACRA Will Impact Your Practice? Not Sure - 62%, Negatively - 15%, No Impact - 14%, Positively - 9%. Total Responses: 792

When we decided to take a closer look at responses from people who felt knowledgeable about MACRA, a pattern emerged...

How Do You Think MACRA Will Impact Your Practice (Very Familiar Responses Only)? Not Sure - 29%, Negatively - 22%, No Impact - 14%, Positively - 35%. Total Responces:84

The majority of healthcare professionals who are very familiar with MACRA believe it will have a positive effect on their practice over the next three years (35%). While the percentage of those who are unsure (30%) was cut in half.

Throughout the survey, we’ll take a look at how familiarity with MACRA largely impacted the responses we received.

Financial Impact

The bottom line: Medicare Part B clinicians want to know how MACRA is going to affect their financial health. We asked practices to consider MACRA’s effect on their financial well-being over the next three years.

61% said they have no idea how MACRA will affect their practice financially. The rest were divided fairly evenly among a positive, negative, or neutral outcome.

MACRA Savvy Professionals Predict a Positive Financial Impact

39% of those comfortable with MACRA believe it will have a positive impact on the financial well-being of their practice. This was a larger percentage than even the “I’m not sures,” which dropped to 31%.

MACRA's Future Impact on Your Practice's Financial Wellbeing (All Responses)? Not Sure - 61%, Positive - 10%, None - 10%, Negative - 19%. Total Responses:783. MACRA's Future Impact on Your Practice's Financial Wellbeing (Very Familiar)? Not Sure - 31%, Positive - 39%, None - 7%, Negative - 23%. Total Responses:83.

Small Practices Not Confident About Their Financial Health

Financial well-being is where small and large practices begin to disagree. While the majority of both groups feel uncertain, small practices ultimately foresee a negative financial future. Large practices predict a positive one.

MACRA's Future Impact on Your Practice's Financial Wellbeing (Small Practices)? Not Sure - 58%, Positive - 7%, None - 10%, Negative - 25%. Total Responses:507. MACRA's Future Impact on Your Practice's Financial Wellbeing (Large Practices)? Not Sure - 66%, Positive - 16%, None - 8%, Negative - 9%. Total Responses:225.

Administrative Impact

When it comes to reporting, the majority of professionals (58% ) have no idea how MACRA will impact their workflow. However, of those who feel comfortable making a judgement call, 27% believe they will spend more time reporting. Only 3% believe they will spend less time on reporting.

Large and Small Practices Agree: MACRA Means More Time Reporting

Both small and large practices came to a consensus in regards to reporting requirements. They feel mostly unsure about how MACRA will affect the amount of time spent on reporting, but agreed it will be more.

MACRA's Future Impact on Your Practice's Time Spent Reporting (Small Practices)? Not Sure - 54%, More Time - 32%, Less Time - 2%, No Change - 12%. Total Responses:512. MACRA's Future Impact on Your Practice's Time Spent Reporting (Large Practices)? Not Sure - 63%, More Time - 16%, Less Time - 3%, No Change - 13%. Total Responses:229.

MACRA Savvy Confident They’ll Spend More Time Reporting

One thing’s for sure: those who know about MACRA agree about reporting requirements. While the majority (48%) expect to spend more time reporting, 25% expect their administrative burden to stay the same.

MACRA's Future Impact on Your Practice's Time Spent Reporting (All Responses)? Not Sure - 58%, More Time - 27%, Less Time - 3%, No Change - 12%. Total Responses:792. MACRA's Future Impact on Your Practice's Time Spent Reporting (Very Familiar)? Not Sure - 17%, More Time - 48%, Less Time - 9%, No Change - 26%. Total Responses:84.

Keep in mind, the majority of these clinicians also see MACRA as being beneficial to their practice despite knowing they’ll spend more time on reporting. That’s good news!

Note: Based on CMS’s 2018 proposals, we expect the number of practices required to participate in MACRA to drop significantly in 2018. This is great news for small practices.

Impact on Quality of Patient Care

When asked how MACRA will affect the quality of care, 62% of respondents weren’t sure. The rest were split pretty between MACRA worsening, improving, or doing nothing at all to impact the quality of patient care. Long story short, there's a lot of uncertainty.

MACRA Savvy Split on Patient Care Effects

Those very familiar with MACRA were also decisively split. Some expect patient care to worsen (30%), while others expect to see it improve (28%).

MACRA's Future Impact on The Overall Quality of Patient Care (All Responses)? Not Sure - 62%, Worsen - 16%, Improve - 10%, No Effect - 12%. Total Responses:790. MACRA's Future Impact on The Overall Quality of Patient Care (Very Familiar)? Not Sure - 21%, Worsen - 28%, Improve - 31%, No Effect - 20%. Total Responses:82.

Large Practices Slightly More Optimistic

When asked if MACRA would improve patient care, both small and large practices were unsure. However, those in small practices believe the care quality will suffer, large practices suspect it will improve.

MACRA's Future Impact on The Overall Quality of Patient Care (Small Practices)? Not Sure - 60%, Worsen - 21%, Improve - 7%, No Effect - 12%. Total Responses:512. MACRA's Future Impact on The Overall Quality of Patient Care (Large Practices)? Not Sure - 65%, Worsen - 7%, Improve - 16%, No Effect - 12%. Total Responses:227.

Impact on Cost of Patient Care

65% of respondents feel uncertain about MACRA’s impact on the cost of healthcare for patients. However, many (20%) think it will be negative.

Respondents indicated they expect both patients and practices will shoulder the financial burden of MACRA. We expected to see everyone pick one or the other. Proof that professionals are experiencing both uncertainty and pessimism about MACRA.

Small and Large Practices Unsure About Cost

When it comes to patient care, small and large practices are both unsure how MACRA will affect costs. Small practices, however, think it’s more likely to have a negative impact while large practices are split equally between positive and negative outcomes.

MACRA's Future Impact on The Overall Cost of Patient Care (Small Practices)? Not Sure - 62%, Negative - 25%, No Impact - 8%, Positive - 5%. Total Responses:512. MACRA's Future Impact on The Overall Quality of Patient Care (Large Practices)? Not Sure - 65%, Negative - 13%, No Impact - 9%, Positive - 13%. Total Responses:224.

MACRA Savvy Think Patients Less Likely to Benefit

Those who know more about MACRA were split fairly evenly about the future cost of healthcare for patients. 32% think it will have a negative impact on the price of care, but that’s only slightly more than those who weren’t sure (28%).

MACRA's Future Impact on The Overall Cost of Patient Care (All Responses)? Not Sure - 65%, Negative - 20%, No Impact - 8%, Positive - 7%. Total Responses:782. MACRA's Future Impact on The Overall Quality of Patient Care (Very Familiar)? Not Sure - 28%, Negative - 32%, No Impact - 17%, Positive - 23%. Total Responses:83.

Specialty Spotlight: Mental Health

Mental Health Specialties Icon

Many who responded to our survey identified as mental health professionals, so we’ve added the following specialty-specific analysis.

We included anyone who labeled their specialty as licensed professional counseling, neurology, neuropsychology, mental health, psychiatry, or psychology.

Nearly 60% of our mental health professionals are practice owners and 58% work in 1-3 provider practices.

Majority of Mental Health Professionals Not Familiar with MACRA

According to our survey, more mental health professionals feel unfamiliar with MACRA (56%) than the general population. Only 4% said they felt very familiar.

MACRA's Future Impact on The Overall Cost of Patient Care (All Responses)? Not Sure - 65%, Negative - 20%, No Impact - 8%, Positive - 7%. Total Responses:782. MACRA's Future Impact on The Overall Quality of Patient Care (Very Familiar)? Not Sure - 28%, Negative - 32%, No Impact - 17%, Positive - 23%. Total Responses:83.

57% do not currently use the Physician Quality Reporting System (PQRS).

Mental Health Professionals Less Optimistic about MACRA

Mental health professionals are largely uncertain about what to expect as a result of MACRA. More than half (70%) could not decide how the switch to value-based care would impact their practice, while just 2% said they expect the outcomes to be positive.

The majority (72%) was also unsure how changes brought on by MACRA will impact the amount of time spent on reporting.

MACRA's Future Impact on The Overall Cost of Patient Care (All Responses)? Not Sure - 65%, Negative - 20%, No Impact - 8%, Positive - 7%. Total Responses:782. MACRA's Future Impact on The Overall Quality of Patient Care (Very Familiar)? Not Sure - 28%, Negative - 32%, No Impact - 17%, Positive - 23%. Total Responses:83.

Note: 60% of mental health professionals say they have not encountered any information on MACRA.

When asked about MACRA’s impact on the cost of healthcare, 76% of mental health professionals said they were unsure, but many (14%) expect it to be negative. We also asked for their thoughts on how MACRA would impact the quality of care and received a similar response.

MACRA's Future Impact on The Overall Cost of Patient Care (All Responses)? Not Sure - 65%, Negative - 20%, No Impact - 8%, Positive - 7%. Total Responses:782. MACRA's Future Impact on The Overall Quality of Patient Care (Very Familiar)? Not Sure - 28%, Negative - 32%, No Impact - 17%, Positive - 23%. Total Responses:83.

The Advantage of Understanding MACRA

Though the numbers seem bleak, there is one positive take away: Professionals, who understand MACRA, are increasingly optimistic.

It may seem like an obvious conclusion, but it’s a necessary one. And we have the data to back it up.

We discovered that despite knowing they’ll spend more time reporting, respondents who are very familiar with MACRA believe it will ultimately have a positive impact on their practice over the next three years.

More thoughts on MACRA? Leave a comment below to join the discussion. Or, continue on to browse through our collection of resources.