Table 6.

Challenges with MACRA Preparations - Heart of Virginia Healthcare, 2018 (n =16)

Practice Ownership
IndependentHospital Owned
Challenges with MACRACapability of the EHR
[I7]: “So that’s where the pain portion is, is with the EHR.”
[I2]: “Once you ask the computer to go ahead and start manipulating the data, now you’ve got a problem.” Lack of Financial Resources
[I7a]: “So, is there a cost [related to MACRA]? Absolutely there is a cost. And do docs see less patients? The answer is yes. They do see less patients than they used to.”
[I7b]: “We wear multiple hats here in our independent practice. We have to be very creative in how we [do things], and [be] resourceful with our employees. So, having resources that are knowledgeable and reputable, that could benefit. You know, it was me going through these steps and preparing for MIPS.”Time Scarcity
[I2]: “One to three hours every night, and I do spend one to three hours [on] MACRA.”[I2]: “Yes, because you can see 100 patients a day. It’s going back and charting on what their issue is. Because, you can see the patients, you can take care of them but there is so much documentation that they’re going to require until we see a revamping of that, of the whole system. I think it’s going to have to come.”
[H4]: “Well, we’re, also have [third party organization]. Have you heard of [third party organization]? We have an outside consultant that’s helping run this whole deal. So yes, so [larger organization] hired them to.”
Analytic Themes“Independent practices have more challenges with MACRA reporting”
  • n = 16 (independent = 8; hospital owned and health-system affiliated = 8).

  • MACRA, Medicare Access and CHIP Reauthorization Act; EHR, electronic health record.