Healthcare Insights from MGMA17

MGMA17, one of the largest healthcare conferences in the country, took place in Anaheim, California, in October. The theme for this year’s conference was “empowerment” and who better to kick off this event than award-winning actress Viola Davis. In her keynote, Viola shared how overcoming adversities and preconceived restrictions – in both her personal and professional life – contributed to reinforcing her abilities as an artist and becoming a stronger woman. Her opening presentation helped to create an enthusiastic buzz, setting the stage for empowering change.

While I wish I could have stayed at MGMA longer, I feel confident enough to say I was in attendance long enough to gain insight and develop observations on the event. Here are two in particular:

1. MACRA madness

Although the theme for MGMA17 focused on empowerment, it became clear that many physicians and practice managers feel anything but empowered. A top of mind concern for many are the challenges to providing high-quality patient care while managing the myriad of Medicare regulatory requirements. This was especially clear from the results of a pre-conference survey that revealed the magnitude of regulatory demands on physicians, forcing medical group practices to needlessly focus time and resources on administrative tasks instead of patient care. The following issues were also identified as “very” or “extremely” burdensome:

  • Medicare Merit-based Incentive Payment System (MIPS) – 82%
  • Lack of national electronic attachment standards – 74%
  • Audits and appeals – 69%
  • Lack of EHR interoperability – 68%

Dr. Halee Fischer-Wright, MD, MMM, FAAP, CMPE, President and Chief Executive Officer at MGMA called for a “national effort to relieve physician practices from excessive government regulation and looks forward to working with both the Administration and Congress to find meaningful solutions.” A survey conducted at the conference however, demonstrated little confidence from participants, in Congress fixing the U.S. healthcare system.

Clearly many within the healthcare space feel overwhelmed by the increasing administrative and regulatory burdens. As a leading revenue cycle and health information management solutions partner to physician practices nationwide, we were there to provide expert guidance and possible solutions to solve such challenges. With a vast portfolio of solutions tailored specifically for the physician practice including HCC optimization services, problem list management solutions, and physician clinical documentation improvement programs, we can help to maximize profitability and decrease administrative burden, allowing physicians to spend more time delivering quality care to their patients.

2. Value-based care

The feature session, “The Evolution of Value-based Care and Risk-based Reimbursement Models from a Physician Practice Perspective” further reinforced concerns around the changes happening to physician practice reimbursement. For those looking to go down the path of risk, the advice offered was to “Think about what you have to do to succeed. Think about your health system partner. Be sure your physicians know what they’re getting themselves into.” In his session, Michael Cuffe, MD, MBA, President HCA Physician Services Group, made very relevant points about the reality of taking on risk, stressing its difficulty and the current lack of preparedness of most practices to succeed in this environment. Cuffe talked about the investments needed in EHR infrastructure and the generational change needed for physicians trained in years of fee-for-service medicine.

Much of the value-based world has been spurred on by government legislation, including the Affordable Care Act (ACA). But even with the ACA’s uncertain future, value-based care and reimbursement is not likely to disappear anytime soon. It’s no secret that healthcare spending per capita in the U.S. far outpaces other countries with similar standards of living, while U.S. outcomes, such as life expectancy and infant mortality, are worse than would be expected based on the amount of money flowing through our system. As such, many organizations, from the U.S. government to private insurance companies, are looking to models that can promise lower healthcare costs while maintaining positive patient outcomes and increased quality of care.

Looking ahead

Regardless of the uncertainty of increasing government regulations, MGMA leadership made every effort to demonstrate a spirit of empowerment in confronting these challenges. There can be no doubt that physician practice reimbursement is going through a major transition with risk-based reimbursement models. And even though physicians now have the added burden of having to identify opportunities for improvement in cost, quality of care, and compliance; the good news is that other healthcare settings have already traversed the myriad of challenges associated with risk-based reimbursement – and done so triumphantly. Seeking expert advice on how best to navigate through these turbulent waters is also a better strategy for success.

MGMA17 was full of connections, education and insights into the key issues facing healthcare today. This article serves as a glimpse into the 2017 MGMA experience. What was your top takeaway from MGMA17? What do you think will be hot topics for MGMA18?

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