Operating costs cause execs' grief

Operating costs provide physician execs with the most griefPhoto used with permission from Shuttershock.com

The sixth installment of Medical Practice Today: What members have to say has come to pass courtesy of MGMA-ACMPE and this year’s 1,067 executive responders, who shared their current struggles and adjustments during times of intense industry progression, under intense legislative pressures.

“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 L. Turney, MD, MS, FACMPE, FACP, MGMA-ACMPE president and CEO, in a news release. "They are working diligently to manage rising operating costs and prepare for potential cuts to reimbursement rates, and are also navigating a number of other transformative federal policies that will soon go into effect, such as health insurance exchanges. It’s understandable that financial management issues rank among the most pressing concerns for our members.”

Concerning the top five most prevalent challenges group practices presently face, the report participants returned with the following ranking:

  1. Dealing with rising operating costs.  
  2. Preparing for reimbursement models that place a greater share of financial risk on the practice.  
  3. Managing finances with the uncertainty of Medicare reimbursement rates.    
  4. Collecting from self-pay, high-deductible, and/or health savings account patients.
  5. Understanding the total cost of an episode of care.

And the hurdles certainly did not end there.

Problems regarding payer collaboration on the basis of new payment models were also highlighted by the respondent cohort.

“Closer working relationships between payers, physicians, hospitals and other providers are critical to the success of emerging payment models," said Anders Gilberg, senior vice president of government affairs, MGMA-ACMPE, in a prepared statement. "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. 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.” 

Systematic necessity was also indicated in the report as paramount to securing smoother operations given the modern climate in the practice management world.

“A patient-centered organization will continually seek ways to better understand the communities they serve,” Todd Evenson, director, data solutions, MGMA-ACMPE, elaborated for the release. “It’s to be expected that practices will need information and resources to manage the health of their populations in the future.” (Refer to the figure below for statistics regarding systems and payment/payer qualms.)


All information and data courtesy of MGMA-ACMPE. Presentation by PhysBizTech.

EHR issues warranted a separate wake pool all their own, according to practice executives. Although actual implementation does seem to be less nettlesome than it was in years prior, the respondents were quick to point out that optimizing an existing EHR has become more of a hassle.

“In the past couple years, practices have struggled to optimize their EHR system,” said Derek Kosiorek, principal consultant, MGMA Health Care Consulting Group, concluded. “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.”

Find a copy of the full report here.

Photo used with permission from Shuttershock.com.