Like it or not, ready or not, MACRA is coming.

Anxiety is rippling through the healthcare industry as the initial reporting period for Medicare’s new payment system for physicians fast approaches. Modern Healthcare’s latest CEO Power Panel survey reveals leaders are bracing for uncertainties and challenges generated by the law, formally titled the Medicare Access and CHIP Reauthorization Act.

This coming phase will be extremely painful for doctors, CEOs worry, even as they applaud the overarching goal of paying for healthcare on the basis of quality over quantity. They are keenly aware of the near-term challenges of managing these growing pains and of successfully mitigating potential negative consequences. But they are also optimistic—even confident—that patients and physicians stand to benefit in the long run.