Close to 6,000 medical practice executives, administrators, physicians, vendors and industry experts attended the annual meeting of the Medical Group Management Association (MGMA) in Nashville. Attendees explored cutting-edge technologies, best practices and hands-on techniques to optimize the financial side of physician practices. In particular, there was a heads-down focus on the practical aspects of making physician practices more efficient and profitable, in five areas in particular:
ICD-10 transition. The International Classification of Diseases, 10th edition (ICD-10) finally went live on October 1st, and there was a lot of pent-up anxiety around its launch. Not unlike the year 2000 (Y2K) exercise: there was considerable angst in the provider community but a lot of behind-the-scenes work by many stakeholders to make it happen without major incident. As a result, the overall launch went relatively smoothly and most glitches appeared to be identified and dealt with quickly. Having gotten through the initial introduction of ICD-10 in the health care system, physician practices at MGMA were interested in learning how to use it. Many vendors were offering to help practices code to ICD-10 and tools to ease the conversion from ICD-9 to ICD-10. That makes sense because coding affects revenue streams for physician practices. Incorrect codes translate to lost or delayed reimbursements. The transition to ICD-10 will continue to be a concern among physician practices for the next couple of years.
Electronic health record integration. Large groups and integrated delivery networks (IDNs) continue their rapid acquisition of physician practices. With that comes the acquisition of a mish-mash of electronic health records (EHRs), which — for a variety of reasons — don’t necessarily play nicely with each other or with the new corporate system. Integration of EHRs within physician group practices and IDNs, as well as the overall need for interoperability, continues to be a focus of activity.
Meaningful use (MU). Plenty can be said about MU, despite the fact that its influence is clearly waning. Implementation of MU stage 2 continues to be problematic. Physicians still are unhappy about its requirements and timeline. Fewer than 10% of eligible professionals were able to attest for MU2 in 2014. Plus, the sands continue to shift around MU stage 3. The required functionality for MU3 continues to change as the government issues new regulatory guidance. There’s also a wild card in the mix. The draft stage 3 regulations were developed before the government had the opportunity to assess the structure, requirements and impact of the new Merit-Based Incentive Payment Systems (MIPS). It was created under landmark Medicare reform legislation, the Medicare Access and CHIP Reauthorization Act of 2015 or MACRA. MACRA rolls up MU, the Physician Quality Reporting System (PQRS) and Value-Based Payment Modifier (VBPM) into MIPS. Regulatory guidance for MIPS has yet to be issued and presumably will need to be reconciled with what’s been proposed already for MU3. At the same time, the proposed 2015 edition health information technology (health IT) certification criteria call for an aggressive readiness timeframe for EHR vendors, which must produce compliant offerings by 2018.
This creates consternation among physician practices, a large number of which are ready to change or upgrade their EHRs. What functionalities will be needed and which systems will be certified? Nobody wants to buy a product that won’t stand the test of time, be noncompliant with regulatory requirements or not meet practice needs.
Vendors, in the meantime, seem to have two takes on the situation: they are skeptical about what the future holds for MU or are fatalistic about having to get with the program — even if it’s years down the road. Some are taking advantage of the breaks in the MU action to beef up their analytics offerings. At MGMA, this translated to analytics for the business side of the practice. That said, we can expect to see enhanced analytics being offered for the clinical side of the practice as well.
Meaningful use was not a prominent theme at MGMA. It seems that providers are paying less attention to the incentive program and turning to tactical matters of optimizing reimbursement and growing their businesses. Vendors have relegated MU to “table stakes” status — all EHRs are MU certified, so let’s talk about the features and functionalities that are unique to our product versus the competition.
Patient engagement products lose appeal. Patient engagement is an MU requirement. For a while, patient engagement created a buzz in physician practices by vendors marketing apps, programs and gimmicks purported to make patient engagement a reality. Venture capitalists began paying attention to patient engagement products, which come in all shapes and forms. However, physician practices are not using them. The marketplace has realized that patient engagement gimmicks are just that: attention grabbers that have limited utility in the overall business of trying to engage patients in their health.
Interest in regulations. The changing regulatory landscape on both the federal and state levels has implications for how practices do business, how they are reimbursed, and what technological requirements will be needed to comply. That reality was not lost on many of MGMA attendees, who tend to represent practices’ back office and compliance functions. There was considerable interest in staying current with regulatory changes, particularly those relative to electronic prescribing (ePrescribing). That is due in part to the numerous practices that are coming onboard with electronic prescribing for controlled substances (EPCS) — in general and in response to states requiring EPCS to fight the rising tide of abuse of opioids and other prescription medications.
Edited by
Kyle Piscioniere
