MACRA – Part 3: The Toxic Side Effects
In the Part 2 Blog in this series, the critical success factors for MACRA were identified. Although they are challenging, they can all be eventually achieved if they have the full support of the physicians. It would seem that all physicians would support achieving the components of the value equation for all those that they serve, that being improving clinical quality and service quality, while controlling or reducing costs. And, in addition, it seems to make great sense that the way to assure sustainable value is to align the payment model with the achievement of metrics which sets best practice goals for each of the components.
Unfortunately, physician's support, which seems so simple and reasonable on the surface, will be hard to achieve. Why? Because MACRA is contributing to an increasing number of extremely dissatisfied physician's, a significant toxic side effect of CMS’s payment reform program.
In a recent study commissioned by the Physician Foundation, it was showed that 1 in 2 physicians are demoralized or dissatisfied. More detailed findings of this study were reported on the September 19, 2016, Web Page of the Heath Leaders Medical News. Specifically, it highlighted the following:
Because this study is depicting the realities of the physician environment today, integrating physicians positively will be a steep mountain to climb. Yet, it is so critical for success that one our first blogs published nearly four years ago was a four part series on this exact topic. Because establishing strong physician partnerships continued to be the number one priority of healthcare leaders, two years ago we published a two part blog series entitled, Strategies to Put Physicians on the Offensive. It probably would be worth your time to go back and review these blogs once again. They will remind us all that strategies must be developed to “connect the physicians” so they can respond as well-informed professionals, putting forth their positions based on careful analysis of accurate data. Some of the strategies that we put forth, having used them successfully, included:
In summary, the anger which many physicians are expressing today is real and must be recognized. But successful payment reform driven by the Value Equation will only be achieved by enhancing physician integration, convincing them to become active partners in this continuing journey. This is best accomplished by identifying and implementing proven strategies to move physicians to the offensive, utilizing their voices to help develop solutions to the many challenges facing the healthcare industry today! They will not be satisfied or successful sitting in the back seat. They are the drivers!