Reimbursement rates jump near top of practice manager concerns

A survey of members of the Medical Group Management Association (MGMA) shows that practice managers are concerned with three main challenges: dealing with rising operating costs; managing finances with the uncertainty of Medicare reimbursement rates; and selecting and implementing a new EHR system.

"It is not surprising that 'maintaining finances with the uncertainty of Medicare reimbursement rates' jumped to the No. 2 spot this year due to the continued congressional irresponsibility in not permanently addressing the flawed sustainable growth rate formula," said William F. Jessee, MD, president and CEO of MGMA.

Medicare reimbursement rate uncertainty had ranked No. 5 in both the 2008 and 2009 member surveys.

An organizational governance issue MGMA introduced to the list this year, "managing teamwork and group dynamics among physicians," debuted at No. 8. "Implementing a patient-centered medical home model of care" made the biggest leap from last year's list—from No. 22 to No. 12.

"Practices are clearly balancing the very serious issue of keeping their practices afloat amid unprecedented financial uncertainty with the more delicate practice management issues such as managing group dynamics and overseeing their organizations' strategic direction," Jessee said.

MGMA found that when compared with independent medical practices, hospitals and health system respondents were more likely to find the following issues challenging:
  • Modifying physician compensation methodology;
  • Recruiting physicians;
  • Dealing with rising operating costs; and
  • Implementing a patient-centered medical home model of care.

However, hospitals and health system respondents were less likely than independent medical practices to be challenged by "maintaining physician compensation levels" and "negotiating contracts with payors."

For a second year, MGMA also asked study participants how the recession is affecting their medical groups and how they are responding. The participants indicated the effects of the recession on their practices are:
  • Improved billing collections and/or denial management processes;
  • Decreased revenue;
  • An increase in uninsured patients;
  • Postponed capital expenditures; and
  • Operating budget cuts.

While these same issues ranked as the top five issues in 2009, the percentage of respondents who saw an increase in uninsured patients or postponed capital expenditures dropped this year. Among the ranking of the recession's effects, "staff salary freeze" accounted for the biggest jump in rank, moving up from No. 12 to No. 6.

MGMA had invited its 21,000 members via email to participate in the web-based questionairre. From February 12 through March 5, the organization received responses from 1,798 individuals.

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