Table 4.

Impact of the Quality Payment Program (QPP) on Practices' Finance, Workflow, and Patient Care - Heart of Virginia Healthcare, 2018 (n = 16)

Financial ImpactWorkflow ImpactPatient Care Impact
Impact of MACRA[I1]: “Probably not a huge amount of [positive] impact [on practice’s finance] because, right now, it’s just Medicare and Medicaid.”
[I7]: “Sure. I didn’t have an [administrative staff] 10 years ago. Or at least [admin. staff] wasn’t doing this job [MACRA related work] 10 years ago.”
[I1]: “Probably not make a big difference in workflow [and workload]. Because so much of it is captured by the EHR.”
[I6]: “We are trying not to let it have a [negative] impact on our workflow [because of the way we chart].”
[H8a]: “Well, I would say there’s a lot of those things that the [MACRA related] documentation slows you down because you think you’ve documented but it’s not going into whatever little box that they want checked.”
[H8b]: “Yes, it’s [MACRA processes] added a big burden to the nurses because there’s a lot of more, a lot more stuff they have to do in the rooming process, boxes that have to be checked and questions that have to be asked and all of that stuff has added a lot of time to the rooming process.”
[I1]: “I don’t think it’s [quality payment program] going to improve [our patient care].”
[I7]: “Is it [the impact of MIPS] measurable? I don’t know that can measure it [improvement in patient care]. I think we all have our opinions about that.”
[H8]: “I don’t think [QPP will improve our patient care] so because I think it’s being done [now] but it’s just not necessarily being [a priority before]…So essentially, this stuff [MACRA measures] was kind of being done it’s just being tracked now and it’s more of a priority [now].”
Analytic Themes“Mixed perceptions toward the impact of the QPP on practices’ finance, workflow, and patient care.”
  • n = 16 (I, independent practice = 8; H, hospital-owned practice = 8).

  • MACRA, Medicare Access and CHIP Reauthorization Act; EHR, electronic health record; MIPS, merit incentive payment system.