Should More Doctors Think About MACRA Like Med School? – MACRA Monday

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program.

While at the recent MGMA Annual conference I ran into Dr. Robert Wah at the CSC Health booth. Dr. Wah has a fascinating background as the former President of the AMA and was also the first Deputy National Coordinator for Health IT back in the Brailer days before now becoming Global Chief Medical Officer at CSC. No doubt he’s seen the full evolution of healthcare IT.

During our chat, Dr. Wah expressed some concern about doctors decision to not properly prepare for MACRA. Between the Pick Your Pace options which basically mean doctors don’t have to fully participate in 2017 and the MACRA final rule being published with a comment period, many doctors have decided to just sit back and not worry about MACRA for now. Those doctors argue that they should wait until the comment period is over to see if the final rule will be changed or they just figure they’ll worry about MACRA in 2018 when they have to fully participate.

Dr. Wah explained to me that this is a dangerous strategy for doctors to employ. He then compared this strategy to medical school. Dr. Wah said that medical students realize pretty early on that they can’t just cram for a class the day before the test in medical school. If students get behind in their studies, then it’s really hard for them to catch up before the test.

Dr. Wah argues that this is what many doctors are doing with MACRA and it could lead to problems. Much like in medical school, it won’t be possible to “cram” for MACRA right before a doctor must fully participate in 2018. Instead, doctors need to use 2017 to appropriately “study” for the MACRA test that’s coming in 2018.

Thanks to Pick Your Pace, CMS have given doctors a pretty big window to make sure that they’re ready for everything that’s required with the full MACRA requirements in 2018. Those that sit on their hands in 2017 will be complaining about how hard MACRA is in 2018. Those that fully participate in 2017 will likely not worry much about the MACRA requirements in 2018.

Be sure to check out all of our MACRA Monday blog posts where we dive into the details of the MACRA Quality Payment Program.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference,, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


  • Im guessing Dr Wah does not do MU/PQRS/MACRA.
    We are burned out on all the data entry, reporting, lame attempts to quantify our “value”.
    Only 20% of eligible doctors do PQRS and MU. 180000/about 1000000.
    Many are just fine taking the penalties if that makes CMS feel better. But we have had enough of this mess. Its is VERY intrusive and VERY complicated to get the reporting correct, so even if you spend HOURS pouring over the data, CMS, your registry, etc can get the numbers wrong and no one will know until at least 18 months later. And good luck trying to get the QRUR (the PQRS report). It takes HOURS to complete all the steps and MANY times it just does not work.
    We are extremely busy just trying to do what our license wants us to do. Take care of patients. We do NOT do data entry well. We do not want to do data entry well. We do not want to play games of risk for AAPM, ACO, and 6 measures, CPIA, etc. If MU and PQRS were so wonderful, we would know by now that safety security cost usability burden etc. would be improved. Its been 6 years of that. Have EHRs and all this data counting clicking attesting numerators and denominators improved anything? Prove it, if you say yes. They only thing its done is distract an already very stressful profession.
    So Dr Wah, we do not want to do MACRA. Just like this last election, the CMS and ONC folks are NOT listening and if you do NOT have buy-in by your constituents, ie MDs, the program is going to fail.

  • I think Dr. Wah is on to something. Providers really need to use the extra time CMS has given them in 2017 to prepare their MACRA workflows. I’ve seen it too many times that providers and administrators wait until the last minute to look at incentive program reports. These practices end up missing out on incentive payments and face negative payment adjustments on reimbursements. I understand that is it a lot of work to adjust workflows for providers, but once they have the workflow down it becomes second nature to them. I feel that doing extra work in the beginning pays off when the doctors see the incentive payments come through. Great article, John!

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