Do surgeons in your
Does your practice
work with primary care
physicians in a medical
home recognized by
or other payors?
money set aside to withstand these fluctuations (see
Figure 6, page 45).
For MACRA to reach its ultimate goals of improving
Conclusion and resources
care while reducing costs, integration of care is essen-
tial. To address this aspect of MACRA preparedness,
the Governors were asked whether their practices are
involved with other specialty service lines and if they
participate in medical homes. When asked whether
their practice works with primary care physicians in
a medical home recognized by insurance companies
or other payors, just 28 percent of surgeons in aca-
demic practice, 39 percent in hospital-based practice,
and 19 percent in private practice responded in the
affirmative (see Figure 8, this page). Furthermore,
less than 40 percent of respondents’ practices were
involved with medical homes ( 39 percent for hospital-
employed surgeons), but on a brighter side, academic
surgeons ( 70 percent) and hospital-employed surgeons
( 57 percent) have practices with clinical service lines
aligned with other specialties (see Figure 9, page 47).
MACRA is a bipartisan legislation developed with input
from numerous stakeholders. In spite of uncertainties
in Washington, DC, it is clear that pay for performance and value-based purchasing—key concepts
that drive MACRA and the QPP—are here to stay.
The Governor’s survey revealed that many
surgeons are exposed to value metrics and are interested in taking steps to improve quality of care and
their performance. However, many Governors are
unfamiliar with how MACRA and the QPP define
achieving these goals and the steps they will need
to take to qualify for positive payment adjustments
in the future.
As surgeons, we are trained to evaluate and adapt.
Like other health care professionals, surgeons adopt