MACRA appears safe, but problems persist for healthcare providers

Thursday, July 27th, 2017

While the 2016 presidential election results have left many wondering what the future holds for the Affordable Care Act, it's unlikely President-elect Donald Trump will interfere with the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

"The (MACRA) law was a notable and rare bipartisan effort, as it was developed by a Republican Congress and signed by a Democratic president," American Medical Association President Dr. Andrew Gurman told Forbes. "In passing this law, Congress and President Obama made significant improvements to the Medicare payment delivery, easing the burdens on physicians."

However, some medical professionals might disagree with Gurman's diagnosis, at least in terms of payment. According to data from the 2016 Physicians Practice Physicians Compensation Survey, nearly 68 percent of physicians said none of their compensation is dependent on value-based care. Meanwhile, 16 percent said only between 1 to 5 percent of their compensation is dependent on value-based care. Finally, 72 percent of survey respondents noted none of their compensation is related to patient satisfaction measurements.

The same survey found approximately 40 percent of physicians estimate their overhead accounts for between 41 and 60 percent of their revenue. Additionally, nearly 40 percent of physicians said their income has plateaued, with approximately 29 percent saying it has decreased.

"Nearly 40 percent of physicians said their income has plateaued."

Cost optimization must take center stage
With so much uncertainty in today's healthcare space, it's more important than ever for medical professionals to focus on cost optimization. Even seemingly small efforts, such as investing in proper clinical interface terminology, can make a big difference.

For example, IMO 2.0 ETP from Intelligent Medical Objects allows medical professionals to identify potential gaps between dictionaries and clinical quality measures for value-based care. Thanks to automatic updates and improved dictionary maintenance, physicians can save time and avoid terminology searches for outdated concepts.

IMO content integrates with numerous platforms and EHR workflows, helping practitioners achieve increased efficiency while ensuring maximum reimbursement.

Also, with IMO Anywhere, physicians are able to search IMO content outside of their EHRs, using IMO terminologies and training tools anytime.

These tools make it easy to provide clinically accurate documentation at the point of care.

Promoting value-based care through technology
The Deloitte 2016 Survey of U.S. Physicians illustrated slow adoption of value-based payment models among medical professionals. Part of the problem appears to be a lack of necessary tools and data.

For instance, the survey discovered that while 3 out of 4 physicians have clinical protocols, only 36 percent have access to comprehensive protocols for various conditions. Deloitte recommended  physicians be equipped with the necessary tools to better meet performance goals.

Similar issues have been identified by accountable care organizations (ACO). Seventy-nine percent of survey respondents told Premier Research Institute that effectively coordinating care across different organizations has been a challenge due to different levels of health IT sophistication.

In short, the current healthcare landscape demands modern tools and information access to both provide and benefit from value-based healthcare models.

IMO clinical terminology is the most widely used in the industry - find out why.