Becker's Hospital Review

80 CMO / CARE DELIVERY Which Specialties Plan to Participate in MACRA in 2017? By Emily Rappleye A bout 43 percent of physicians said they expected to partic- ipate in the Medicare Access and CHIP Reauthorization Act in an annual Medscape survey. MACRA is technically optional for physicians in 2017. CMS decided to create a gradual ramp to partici- pation and allow physicians to pick their pace for 2017 participation, ranging from no participation — with an associated penalty — to full-on, year-round participation. At the time the Medscape conducted the survey — between Dec. 20, 2016 and March 7, 2017 — 35 percent of physicians remained undecided on how they planned to approach MA- CRA, according to the report. Med- scape's "2017 Physician Compensa- tion Report" includes responses from more than 19,200 physicians. Physicians in the following 10 spe- cialties were most likely to plan on participating in MACRA in 2017, according to the survey. Ophthalmology — 64 percent expected to participate Nephrology — 61 percent Urology — 60 percent Dermatology — 57 percent Cardiology — 55 percent Gastroenterology — 54 percent Anesthesiology — 53 percent Radiology — 50 percent Otolaryngology — 50 percent Family Medicine — 49 percent Specialties least likely to report ex- pected participation in MACRA included psychiatry (19 percent expected to participate), plastic sur- gery (25 percent) and pediatrics (33 percent). n 88% of Second Opinions From Mayo Physicians Result in Different or Refined Diagnosis By Kelly Gooch A number of patients referred to Rochester, Minn.-based Mayo Clinic for a diagnosis confirma- tion or second opinion found they were initially misdiagnosed, according to a study published in the Journal of Evalu- ation in Clinical Practice. For the study, researchers analyzed data on 286 patients referred by primary care practices to Mayo Clinic's General Inter- nal Medicine Division from Jan. 1, 2009 to Dec. 31, 2010. The study found only 12 percent of pa- tients received confirmation of their pre- vious diagnosis. A vast majority of pa- tients (66 percent) found their diagnoses were "better defined/refined" after vis- iting Mayo, and 21 percent saw distinct differences between their final diagno- ses and referral diagnoses, researchers said. According to Mayo, this means up to 88 percent patients left with a new or refined diagnosis. "Effective and efficient treatment de- pends on the right diagnosis," James Naessens, Sc.D., head of the study's re- search team and a healthcare policy re- searcher at Mayo Clinic, said in a news release. "Knowing that more than one out of every five referral patients may be completely [and] incorrectly diagnosed is troubling — not only because of the safety risks for these patients prior to correct di- agnosis, but also because of the patients we assume are not being referred at all." In the release, he said the study also found "total diagnostic costs for cases re- sulting in a different final diagnosis were significantly higher than those for con- firmed or refined diagnoses." However, he noted: "The alternative [to getting a second opinion] could be deadly." Dr. Naessens said in the release he and his research team plan to continue look- ing into diagnostic errors and hope to find improvement measures. n Patient Wait Times Increased 30% Since 2014: 5 Findings By Jessica Kim Cohen T he time patients wait to schedule a physician appointment has reached its highest point in more than 10 years, according to a Merritt Hawkins report. e report, titled, "e 2017 Survey of Physi- cian Appointment Wait Times and Medicare and Medicaid Acceptance Rates," analyzed the time it takes to schedule a new physician appointment in 15 large metropolitan areas and 15 mid-sized metropolitan areas. Here are five things to know. 1. Today, it takes an average of 24 days to schedule a new physician appointment in a large U.S. city. 2. e 24-day average noted in 2017 marks a 30 percent increase since 2014, when the average was 18.5 days. e average was 20.5 days in 2009 and 21 days in 2004, according to previous Merritt Hawkins reports. 3. Of the 15 large cities, Boston experienced the longest average physician wait times, with an average of 52 days to schedule an appointment. 4. Dallas experienced the shortest average phy- sician wait times for the 15 large cities, with an average of 15 days to schedule an appointment. 5. In mid-sized cities, the average time to schedule a new physician appointment was 32 days — 33 percent longer than in the large metropolitan markets. In part, this is because mid-sized cities have fewer physi- cians per capita, said Mark Smith, president of Merritt Hawkins. "Physician appointment wait times are the longest they have been since we began con- ducting the survey," Mr. Smith said. "Grow- ing physician appointment wait times are significant indicator that the nation is expe- riencing a shortage of physicians." n

• Cover
• _GoBack