Jay Rath
Even as healthcare moves toward performance-based incentives, a majority of physicians are finding it to be “a barrier to success,” according to a recent survey conducted by the Medical Group Management Association (MGMA).
The study included 750 group practices. A plurality are independent practices with 6 to 20 physicians.
Of those responding, 84 percent are taking part in the Merit-Based Incentive Payment System (MIPS) during its first year. (In May, the Centers for Medicare & Medicaid Services (CMS) exempted about two-thirds of physicians and other clinicians who provide care to Medicare beneficiaries through MIPS.)
Whether or not they participate, 82 percent of survey respondents find the program to be “very” or “extremely” burdensome.
Among MGMA’s conclusions: Regulatory and administrative burdens are drawing resources away from patient care. Practices so far see little clinical benefit in MIPS. Worse, to accommodate it, non-standardized and even “onerous” transactions are driving up the cost of healthcare.
“Attitudes may change in the future if the program is simplified and made more clinically relevant to delivering patient care,” Anders Gilberg tells Moxe. Gilberg is MGMA senior vice president for government affairs.
Nearly three-quarters of respondents rated the lack of electronic attachments for claims and prior authorization as “very” or “extremely” burdensome. While practices are increasingly dependent on third-party vendors, 40 percent are “very” or “extremely concerned” that vendors aren’t ready for MIPS, and 71 percent are “very” or “extremely” concerned about implementation cost.
Similarly, 68 percent rate the lack of EHR interoperability as “very” or “extremely burdensome.”
“EHR vendors continue to charge addition[al] fees for a ‘package’ to meet MIPS reporting requirements,” complained one participant. “It’s a gold mine for them.”
The purpose of the MGMA study – the first of its kind – was to better understand the cost and challenge of compliance. Nearly half the respondents reported spending more than $40,000 per full-time equivalent physician per year, just to comply with federal regulations.
Despite this, griped one participant, “Most of what we do to meet requirements is busy-work that has no real impact on patient care.”
Findings of MGMA’s Regulatory Burden Survey
- 80 percent of respondents are very or extremely concerned about the clinical relevance of MIPS to patient care.
- 73 percent of respondents believe that MIPS does not support their practice’s clinical quality priorities.
- More than 70 percent of respondents find the MIPS scoring system to be very or extremely complex.
- 84 percent of respondents agree or strongly agree that a reduction in Medicare’s regulatory complexity would allow their practice to reallocate resources toward patient care.
- 93 percent of respondents support a single provider-credentialing source for Medicare, Medicaid, and commercial payers in the United States.
While it’s clear that MIPS is going through a period of refinement, one survey result ironically provides hope; 69 percent of respondents are very or extremely concerned that “unclear program guidance” impacts their ability to successfully participate. That’s a barrier that can be overcome.
The underlying premise of shifting payments to rely more on quality scoring is an asset to heathcare. While there must be better communication and greater guidance from CMS, we all must be willing to share experience and knowledge as adoption grows.
(Based near Denver, MGMA represents more than 12,500 U.S. healthcare organizations of all types. The association claims its members deliver healthcare for nearly half the country.)