OBJECTIVES: Under MACRA legislation, practices may elect to participate in MIPS or APMs. We seek to assess practice readiness for MACRA compliance.

METHODS: During a live meeting conducted in October 2017 we surveyed 21 community rheumatologists (HCPs) and 18 rheumatology practice managers (PMs) representing various practice sizes and geographic locations throughout the United States. Audience response technology was used to capture responses.

RESULTS: Of 21 HCPs, 90% have been in practice over 5 years, 85% use electronic medical records(EMR), and over half follow self-developed clinical pathways or adopted professional society templates. Only two-thirds of HCPs and PMs either have or are actively putting a readiness plan in place; one-quarter don’t understand the changes and seek help. Regarding Pick-Your-Pace strategy: 40% of HCPs and 50% of PMs indicated partial participation; 20% of HCPs and 6% of PMs consider their practice exempt from MIPS; none indicated APM participation; 20% of HCPs and 6% of PMs do not have a strategy. Regarding reporting, 15% of HCPs and 22% of PMs would submit full data, the rest would submit only test data to avoid negative payment impact. A third of HCPs and almost 80% of PMs mentioned that their EMR provider offers MIPS support; 55% of HCPs and 76% of PMs believe that their EMR meets MACRA requirements. Over one-third of HCPs and PMs believed that their practice has capabilities to successfully participate in an advanced APM; 24% of HCPs and 39% of PMs would be willing to participate as a pilot practice to test an RA-focused APM.

CONCLUSIONS: Our research suggests inadequate readiness for robust MACRA implementation. The fact that many practices are exempt, majority chose partial participation and few feel ready to migrate to APM is challenging to this CMS objective. More time and education is needed for practices to understand and prepare for legislation implementation.