Health systems have yet to roll out comprehensive strategies to comply with the Medicare Access and CHIP Reauthorization Act, better known as MACRA, according to a study published by Health Catalyst and Peer60.

Whereas most respondents expect to participate in MACRA, in fact, only 35 percent said they currently have a strategy for doing so.

MACRA consolidates and replaces several value-based reimbursement programs, including the Physician Quality Reporting System, meaningful use and the Value-Based Payment Modifier. The new program has two tracks – one for physician groups called the Merit-Based Incentive Payment System.

Even though 2017 has been designated as the first reporting year, the survey found that some 40 percent of respondents said the biggest challenge is compiling the metrics necessary for regulatory reporting, and 18 percent ranked the second biggest challenge as coordinating care between doctors and patients.

That said, despite the slow progress on MACRA, two-thirds of small and medium-sized hospitals that have a strategy in place expect to either receive a bonus or break even, while one respondent anticipated getting hit with a penalty and nice answered that they are unsure.

The numbers were similar for large hospitals and health systems. Of the 45 respondents from large hospitals and health systems who said they have a MACRA strategy, 36 percent expected their affiliated physicians to earn a bonus while 31 percent said they expected physicians to break even.

Health Catalyst and Peer60 polled 187 healthcare professionals. Respondents included 37 CEOs and 94 other C-Suite executives, such as CFOs, CIOs, CMOs, and CMIOs. Among the organizations represented were some of the country’s largest urban academic medical centers and integrated delivery networks and also small, rural critical access facilities, the companies said.