Practices must surmount daily financial and regulatory challenges


Newly released research from MGMA-ACMPE reinforces the dominance of financial and regulatory concerns among the day-to-day challenges faced by medical practice professionals. The association for administrators and group practice leaders based its findings on 1,252 responses to its fifth annual "Medical Practice Today: What members have to say" survey.

According to the research, the top five most applicable and intense challenges of running a group practice are:

  1. Managing finances with the uncertainty of Medicare reimbursement rates.
  2. Preparing for reimbursement models that place a greater share of financial risk on the practice.
  3. Preparing for the transition to ICD-10 diagnosis coding.
  4. Dealing with rising operating costs.
  5. Participating in the Centers for Medicare & Medicaid Services' EHR meaningful use incentive program.

"The threat of a significant cut in Medicare reimbursement continues to plague physician practices and severely hinders their ability to properly plan and assess their financial situations," said Susan Turney, MD, MS, FACP, FACMPE, president and CEO of MGMA-ACMPE. "The increased regulatory burden brought on by unfunded federal mandates only exacerbates this uncertainly caused by the flawed Medicare Sustainable Growth Rate physician payment formula."

Challenges for physician-owned medical groups and groups owned by hospitals or integrated delivery systems (IDSs) differed slightly. Not surprisingly, merging with another practice posed a bigger challenge for respondents in physician-owned groups than it did for those in hospital-owned or IDS-owned practices. Being acquired by another practice was also more likely to be a challenge for physician-owned medical groups.

Medical practice professionals in hospital- or IDS-owned medical groups found preparing for the ICD-10 diagnosis codes more challenging than those in physician-owned groups. Managing finances, implementing and/or optimizing a patient-centered medical home, and dealing with the commercial-payer physician credentialing process were also cited as a greater challenge for hospital-owned groups.

"The healthcare environment is increasingly complex to navigate," Turney said in a prepared statement. "It's more important than ever for professional practice administrators, especially those who are board-certified in medical practice management, to assist their practices in adapting to the arduous processes and regulations that govern our industry."

Challenges were also ranked by practice size, years of experience in medical practice management and position title.

Here is an at-a-glance recap of the survey results:

MGMA-ACMPE used three different indexes to examine the survey data gathered from an online questionnaire:

  • Applicability index. Members responding to the questionnaire were permitted to indicate when a specific challenge was not applicable to their situation.
  • Intensity metric. Members classified (along a five-point scale) how big of a challenge they considered each issue, from “no challenge at all” to “extreme challenge.” Members rated a total of 54 issues.
  • Applicability-weighted intensity index. MGMA-ACMPE looked at both the applicability and the intensity metrics to examine which challenges topped the charts. These were considered the most extreme challenges applicable to the largest number of our members.

Full analysis appears in the July issue of MGMA Connexion magazine.

Photo attributed to MakKuyper via Creative Commons license.