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2016 Survey of US Physicians
Physician awareness,
perspectives, and readiness
for MACRA
2016 Survey of US Physicians:
Physician awareness, perspectives, and readiness for MACRA
The Medicare Access and CHIP Reau...
Most physicians surveyed are unaware of MACRA. Independent
physicians surveyed are more aware of it than others.
Surveyed ...
Many physicians surveyed recognize they will need new capabilities in order
to bear increased financial risk.
The announce...
Surveyed physicians reported that they
prefer traditional compensation models.
Nearly 8 in 10 physicians surveyed
prefer f...
The majority of surveyed physicians believe
that the performance of the US health care
system can be improved by:
Half of ...
Surveyed physicians open to participating in value-based payment models have more
positive expectations for MACRA and heal...
Most surveyed physicians expect increased physician consolidation, but independents
would prefer joining clinical networks...
Methodology
Since 2011, the Deloitte Center for Health Solutions has surveyed a nationally representative sample of US phy...
About the Deloitte Center for Health Solutions
The source for health care insights: The Deloitte Center for Health Solutio...
Contact us
Mitch Morris, MD
Vice Chairman
Global Life Sciences & Health Care Industry Leader
Deloitte Consulting LLP
mitch...
About Deloitte
Deloitte refers to one or more of Deloitte Touche Tohmatsu Limited, a UK private company limited by guarant...
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2016 Survey of US Physicians: Physician awareness, perspectives, and readiness for MACRA

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The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is a Medicare payment law intended to drive health care payment and delivery system reform for clinicians, health systems, Medicare, and other government and commercial payers. Deloitte’s 2016 Survey of US Physicians sought to shed light on physicians’ awareness of MACRA, their perspectives on its implications, and their attitudes and readiness for change. The survey found that many physicians are unaware of MACRA. Regardless of their awareness level, most physicians surveyed would have to change aspects of their practice to meet the law’s requirements and to do well under its incentives. Many physicians surveyed recognize they will need to bear increased financial risk (under MACRA and in general) and need support and resources to develop the capabilities do so. http://www.deloitte.com/us/macra?id=us:2sm:3ss:macra:eng:lshc:071216

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2016 Survey of US Physicians: Physician awareness, perspectives, and readiness for MACRA

  1. 1. 2016 Survey of US Physicians Physician awareness, perspectives, and readiness for MACRA
  2. 2. 2016 Survey of US Physicians: Physician awareness, perspectives, and readiness for MACRA The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is a Medicare payment law intended to drive health care payment and delivery system reform for clinicians, health systems, Medicare, and other government and commercial payers. The law establishes a path toward a new payment system that will more closely align reimbursement with quality and outcomes. MACRA applies financial incentives for health care professionals to participate in risk-bearing, coordinated care models and to move away from the traditional fee for service system. MACRA’s final rule from the US Centers for Medicare and Medicaid Services (CMS) is expected in fall 2016, and the first performance reporting period under the law begins January 1, 2017. Deloitte’s 2016 Survey of US Physicians sought to shed light on physicians’ awareness of MACRA, their perspectives on its implications, and their attitudes and readiness for change. The survey found that many physicians are unaware of MACRA. Regardless of their awareness level, most physicians surveyed would have to change aspects of their practice to meet the law’s requirements and to do well under its incentives. Many physicians surveyed recognize they will need to bear increased financial risk (under MACRA and in general) and need support and resources to develop the capabilities do so. Copyright © 2016 Deloitte Development LLC. All rights reserved.Source: Deloitte 2016 Survey of US Physicians
  3. 3. Most physicians surveyed are unaware of MACRA. Independent physicians surveyed are more aware of it than others. Surveyed physicians with a high share of Medicare payments are just as unaware of MACRA as others. 21% of self-employed physicians and those in independently owned medical practices report they are somewhat familiar with MACRA versus 9% of employed physicians surveyed. This may be because self-employed and independent physicians are more directly responsible for their practices’ business requirements. 50% of non-pediatric physicians surveyed have never heard of MACRA. 32% only recognize the name. Copyright © 2016 Deloitte Development LLC. All rights reserved.Source: Deloitte 2016 Survey of US Physicians
  4. 4. Many physicians surveyed recognize they will need new capabilities in order to bear increased financial risk. The announcement by CMS of $100 million for training and education of small practice physicians to understand the Quality Payment Program is well timed and needed to help physicians prepare for MACRA. Copyright © 2016 Deloitte Development LLC. All rights reserved. Top needed supporting capabilities reported by surveyed physicians are related to reporting and include: Standardized quality measures 42% Analytics and other monitoring tools to track high-cost patients 29% Standardized cost measures 28% Copyright © 2016 Deloitte Development LLC. All rights reserved.Source: Deloitte 2016 Survey of US Physicians
  5. 5. Surveyed physicians reported that they prefer traditional compensation models. Nearly 8 in 10 physicians surveyed prefer fee-for-service or salary for their compensation. Many physicians surveyed will have to adjust their current approach and practice management based upon MACRA’s specifications. For example they have low preference for most value-based payment models. of physicians surveyed would opt for shared savings, which is not a qualifying Advanced Alternative Payment Model (APM) under MACRA. of physicians surveyed would participate in value-based payment models if offered financial incentives to do so. Performance bonuses currently are less than 10% of current compensation or non-existent for majority of physicians surveyed. of physicians surveyed report receiving performance bonuses that are less than or equal to 10% of their total compensation. of physicians surveyed report that they are not eligible for performance bonuses. Copyright © 2016 Deloitte Development LLC. All rights reserved.Source: Deloitte 2016 Survey of US Physicians
  6. 6. The majority of surveyed physicians believe that the performance of the US health care system can be improved by: Half of surveyed physicians do not support individual public quality reporting as would be required under the Merit-Based Incentive Payment System (MIPS) track of MACRA. 74% of surveyed physicians believe performance reporting to be burdensome and 79% do not support tying compensation to quality. Performance reporting is supported conceptually but public reporting at the individual level is not and surveyed physicians find reporting burdensome. Measuring care outcomes and processes Measuring resource utilization and costs 73% 71% Copyright © 2016 Deloitte Development LLC. All rights reserved.Source: Deloitte 2016 Survey of US Physicians
  7. 7. Surveyed physicians open to participating in value-based payment models have more positive expectations for MACRA and health care transformation more generally. After receiving a brief explanation of MACRA, 23% of surveyed physicians who are willing to participate in value-based payment models with financial incentives indicated that the law would reduce costs, and 19% indicated it would improve quality. Among physicians surveyed willing to participate in value-based payment models with financial incentives, 47% believe that value-based payment models can improve the performance of the US health care system. Only 23% of surveyed physicians who are unresponsive to incentives believe in value-based payment models. Of those surveyed physicians who are unresponsive to incentives, only 9% felt that the law would reduce costs, and 5% said it would improve quality. Copyright © 2016 Deloitte Development LLC. All rights reserved.Source: Deloitte 2016 Survey of US Physicians
  8. 8. Most surveyed physicians expect increased physician consolidation, but independents would prefer joining clinical networks versus being employed. Increased consolidation is expected due to financial pressures in general, not just MACRA. Copyright © 2016 Deloitte Development LLC. All rights reserved.Source: Deloitte 2016 Survey of US Health Care Physicians 58% of physicians surveyed would opt to be part of a larger organization to diminish individual physician risk and bear risk collectively and/or to have access to a full spectrum of resources and capabilities. 80% of those surveyed expect MACRA to drive physicians to join larger organizations or networks. Half of surveyed physicians say financial pressures are the number one driver of consolidation. Both independent and employed physicians surveyed expect that between a third and two-thirds of the remaining independent physicians will consolidate in the next three years. One in four of independent physicians surveyed would prefer to be employed while 75% would prefer to join a clinical network. Copyright © 2016 Deloitte Development LLC. All rights reserved.Source: Deloitte 2016 Survey of US Physicians
  9. 9. Methodology Since 2011, the Deloitte Center for Health Solutions has surveyed a nationally representative sample of US physicians on their attitudes and perceptions about the current market trends impacting medicine and future state of the practice of medicine. The general aim of the survey is to understand physician adoption and perception of key market trends of interest to the health plan, provider, life sciences, and government sectors. The 2016 survey included 600 US physicians and had new questions on MACRA. The national sample is representative of the American Medical Association (AMA) file with respect to years in practice, gender, geography, practice type, and specialty to reflect the national distribution of US physicians. A subsample of 523 physicians (non-pediatric specialties) were asked specific questions regarding MACRA since it specifically targets Medicare payments. The entire sample of 600 were asked about value-based payment models and consolidation. For more information, please visit: www.deloitte.com/us/macra Copyright © 2016 Deloitte Development LLC. All rights reserved.Copyright © 2016 Deloitte Development LLC. All rights reserved.Source: Deloitte 2016 Survey of US Physicians
  10. 10. 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 and rigorous analysis, and providing unique perspectives, DCHS seeks to be a trusted source for relevant, timely, and reliable insights. To learn more, please visit: www.deloitte.com/us/centerforhealthsolutions Copyright © 2016 Deloitte Development LLC. All rights reserved.Copyright © 2016 Deloitte Development LLC. All rights reserved.Source: Deloitte 2016 Survey of US Physicians
  11. 11. Contact us Mitch Morris, MD Vice Chairman Global Life Sciences & Health Care Industry Leader Deloitte Consulting LLP mitchmorris@deloitte.com Anne Phelps Principal US Health Care Regulatory Leader Deloitte & Touche LLP annephelps@deloitte.com Wendy Gerhardt Research Manager Deloitte Center for Health Solutions Deloitte Services LP wgerhardt@deloitte.com Copyright © 2016 Deloitte Development LLC. All rights reserved.Source: Deloitte 2016 Survey of US Physicians
  12. 12. About Deloitte Deloitte refers to one or more of Deloitte Touche Tohmatsu Limited, a UK private company limited by guarantee (“DTTL”), its network of member firms, and their related entities. DTTL and each of its member firms are legally separate and independent entities. DTTL (also referred to as “Deloitte Global”) does not provide services to clients. Please see www.deloitte.com/about for a detailed description of DTTL and its member firms. 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. Copyright © 2016 Deloitte Development LLC. All rights reserved. 36 USC 220506 Member of Deloitte Touche Tohmatsu Limited

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