PHS148 - Readiness of Community Oncology and Urology Practices for Value-Based Care

Abstract

The Centers for Medicare and Medicaid Services (CMS) have published guidelines that reward healthcare providers based on the quality of care instead of quantity. The Medicare Access and CHIP Reauthorization Act (MACRA) focuses on quality, value and accountability in determining reimbursement schedules for various services provided. The goal of this study was to evaluate the understanding and preparedness of community oncologists and urologists to implement changes in their practices to be compliant with the new CMS requirements. Quantitative market research data on various topics were collected from U.S.-based community oncology and urology treatment sites representing >800 physicians at a live event held in June 2017 using audience response system. Most physicians were from large practices and over 70% had basic knowledge about MACRA. Less than half of the representing practices were participating in a qualifying alternative payment model and only 23% were participating in the Oncology Care Model (OCM). Although 60% of the physicians felt that their practices were somewhat prepared for the Merit-based Incentive Payment System (MIPS), practices were facing significant barriers to its success including lack of qualified staff, lack of knowledge regarding MIPS requirements, and cultural shift within the practice. Half of the practices had chosen the specific quality and Advancing Care Information measures to be submitted for 2017 with respect to MIPS. Both MACRA and OCM require practice transformation to deliver value-based care. However, only 21% of the representing practices had implemented practice transformation to drive quality and savings. Overall, half of the practices would implement practice transformation to reduce hospitalizations and emergency room visits as the initial step to drive cost savings. Most oncologists and urologists were aware of MACRA. While they were concerned about impact of MACRA and OCM, most practices were not yet ready to implement value-based care.