Practicing successfully under the Medicare Access and CHIP Reauthorization Act (MACRA) — the biggest change in Medicare payment policies in more than a generation — will call for strong collaboration and communication between physicians and other members of the health care team.
For many physicians, this means a culture shift. Traditionally, medicine has celebrated the physician as a “lone healer” and independent decisionmaker, while the “fiefdom” structure of health care systems undermines collaboration. The new model will require seamless communication as patients transition through the health care system.
TMA outlines this formula for reaching this goal:
- Awareness: This first step may require some self-reflection and honest examination. Many physicians are unaware a communication gap exists between themselves and others, and do not think they are ineffective communicators.
- Understanding the underlying barriers to communication. This will help physicians devise solutions. For example, studies show that that communication between inpatient physicians and the patient’s primary care physician (PCP) occurs in only 3-20 percent of hospitalizations. What’s lacking may be an established system for completing discharge summaries and getting them to the PCP.
- Communication skills training. Seminars defining why communication is important to improve patient care, followed by specific skills training, can be effective. Time spent in group discussion and role play between physicians and health care teams improves success.
- Situation/Background/Assessment/Recommendations (SBAR) team training. This technique, which is the Joint Commission’s stated industry best practice for standardized communication, uses scripting of specific questions and responses to improve communication between two individuals responding to a specific patient need.
- Support. Clinical leaders and administration must commit to a culture of trust, respect, and collaboration. Defining mutual goals is essential for effective team building and improved communication.
- Intervention. As leaders of the health care team, physicians should be held accountable for their role. Physicians who are chronically or obstinately uncooperative may need to be sanctioned or lose privileges.
Want to learn more about MACRA? Contact the Physician Payment Resource Center at (512) 370-1414 to speak with a TMA billing expert.
Published Nov. 10, 2025
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Last Updated On
November 10, 2025
Originally Published On
October 18, 2016