More Doctors To Retire As MACRA And Value-Based Pay Hit

Bruce Japsen | September 21, 2016

The nation’s doctors, facing a tsunami of changes in how they are paid, plan to retire in droves as value-based pay replaces fee-for-service medicine and they are forced to implement more new regulations, according to a new report.
The biennial survey from the Physicians Foundation shows 46% of physicians plan to “accelerate” their retirements, cut back on patients or seek “non-clinical roles,” according to the group’s survey, which is conducted by physician staffing and recruitment firm MerrittHawkins. More than 17,000 physicians are polled, Merritt said.

Not all of these doctors will leave medicine right away, with 14.4 % of physicians saying they will retire in the next one to three years compared to 9.4% in 2014. Meanwhile, 21% say they will cut back on hours and another 13.5% say they will seek a “non-clinical” job in healthcare.

Doctors are being dogged by “poor morale” and “invasive regulations,” according to the survey. This includes payment changes that are requiring physicians to be measured and earn reimbursement from insurers and government health programs based on health outcomes.

The nation’s doctors, facing a tsunami of changes in how they are paid, plan to retire in droves as value-based pay replaces fee-for-service medicine and they are forced to implement more new regulations, according to a new report.

The biennial survey from the Physicians Foundation shows 46% of physicians plan to “accelerate” their retirements, cut back on patients or seek “non-clinical roles,” according to the group’s survey, which is conducted by physician staffing and recruitment firm MerrittHawkins. More than 17,000 physicians are polled, Merritt said.

Not all of these doctors will leave medicine right away, with 14.4 % of physicians saying they will retire in the next one to three years compared to 9.4% in 2014. Meanwhile, 21% say they will cut back on hours and another 13.5% say they will seek a “non-clinical” job in healthcare.

Doctors are being dogged by “poor morale” and “invasive regulations,” according to the survey. This includes payment changes that are requiring physicians to be measured and earn reimbursement from insurers and government health programs based on health outcomes.

“Many physicians are dissatisfied with the current state of the medical practice environment and they are opting out of traditional patient care roles,” said Dr. Walker Ray, president of the Physicians Foundation, in a statement accompanying the report.

Insurers including Aetna AET +0.90%, Anthem WLP +%, UnitedHealth Group UNH +0.76% and Blue Cross and Blue Shield plans are shifting the bulk of their payments away from fee-for-service arrangements that reward volume of care delivered to value-based models that tie reimbursement to quality and outcomes. The Physicians Foundation survey showed 43% of physicians now say they have their pay tied to value-based models.

Doctors are uneasy about these payment changes and surprisingly in the dark about the biggest one to come when they face implementation of quality measures required under the Medicare Access and CHIP Reauthorization Act of 2015 known as “MACRA.” MACRA repealed the flawed sustainable growth rate (SGR) formula railed against by doctor groups for more than a decade because it cut Medicare payments to physicians.

The survey said only 20% of physicians are familiar with MACRA. Meanwhile, 56% of physicians said they were either “somewhat unfamiliar” or “very unfamiliar” with MACRA.

MACRA is bringing merit-based incentive payments as the law shifts away from fee-for-service medicine. MACRA’s payment system brings together three existing reporting programs: the physician quality reporting system, the value-based payment modifier and meaningful use.

“Doctors have been on a slow boil over a variety of issues for years,” said Mark Smith, president of MerrittHawkins “Implementing value-based care and adjusting to MACRA on the fly has turned up the heat a few more degrees. The result is more than hard feelings.”

Source:  Forbes

http://www.forbes.com/sites/brucejapsen/2016/09/21/more-doctors-to-retire-as-macra-and-value-based-pay-hit/#705612ff4261