Physicians rate finances top challenge

Physician executives say that dealing with rising operating costs and preparing for new payment models that put more financial risk on their practice are the top challenges they face in running a group practice, according to the latest MGMA-ACMPE survey released Tuesday.

While physicians handle difficult medical problems as part of their everyday practices, group practices find that managing finances is their toughest daily challenge, including the uncertainty of Medicare reimbursement rates and the difficulty in collecting from patients who are self-pay, high-deductible or use health savings accounts, said a news release announcing the sixth annual survey.

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The survey was based on the responses of 1,067 physician members of the Medical Group Management Association (MGMA) and American College of Medical Practice Executives (ACMPE).

Physicians reported that “collaborating with payers to implement new payment models” was more intense and applicable by respondents than in 2012, the association said in this sixth year of the survey.

Research conducted by the group in October 2012 indicated that 82 percent of responding physician practices were willing to explore new Medicare payment models, but the instability caused by constant threats of reimbursement cuts under Medicare’s sustainable growth rate (SGR) payment formula has gotten in the way of their participation.

Close working relationships between payers, physicians, hospitals and other providers are critical for emerging payment models to be effective, said Anders Gilberg, MGMA-ACMPE senior vice president of government affairs.

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“Physicians need real-time data from payers in order to effectively manage patient populations. Integrated care delivery is the future and it can be facilitated in formal and informal ways,” he said in the release. “As payers increasingly hold physicians accountable for cost and quality metrics, they must implement transparent collaborative approaches to contracting and data-sharing to assist practices in effectively serving their patients.”

Respondents reported that putting in place a new electronic health record (EHR) was less challenging this year, but “optimizing an existing EHR system” was cited as more difficult.

“In the past couple years, practices have struggled to optimize their EHR system,” said Derek Kosiorek, principal consultant, MGMA Health Care Consulting Group, in the release."“It’s important to work with your system vendor to really understand the functionalities of the system and learn how to best integrate these new capabilities with your processes. Some practices may even be using their second EHR system and are working to better optimize it than they did their first system."

Seventy percent of survey respondents also indicated that “using systems to manage and evaluate population health” was very applicable to their jobs in order to gather information and resources to better manage the health of their populations in the future.

Earlier this year, the association released DataDive: 2012 Procedural Profile Module, a resource that practices can use to understand patient bases, explore potential new service lines and assure adequate practice staffing. Practices can develop an organizational profile that can be benchmarked against peers' profiles using national and credible MGMA data.

"Physician practices are doing more and more to innovate and respond to our rapidly changing environment to meet the needs of their patients, but with fewer resources," said Susan Turney, MD, MGMA-ACMPE president and CEO, in the release.

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