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MGMA: Physician Compensation Data Illustrates Nationwide PCP Shortage

May 23, 2018
by Rajiv Leventhal
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Primary care physicians’ compensation rose by more than 10 percent over the past five years, representing an increase which is nearly double that of specialty physicians’ compensation over the same period, according to the Medical Group Management Association (MGMA).

Officials from the Colorado-based MGMA, attested that the data “is further evidence of the worsening primary care physician shortage in the American healthcare system.”

A closer look at this data—the 2018 MGMA DataDive Provider Compensation—shows that this rise in compensation is not necessarily tied to an increase in productivity. When broken down by primary care focus, family medicine physicians saw a 12-percent rise in total compensation over the past five years, while their median number of work relative value units (wRVUs) remained flat, increasing by less than one percent. Practices offered more benefits to attract and retain physicians, including higher signing bonuses, continuing medical education stipends, and relocation expense reimbursements.

The data for this survey was based on comparative data from more than 136,000 providers in over 5,800 organizations.

“MGMA’s latest survey has put strong data behind a concerning trend we’ve seen in the American healthcare system for some time—we are experiencing a real shortage of primary care physicians,” Halee Fischer-Wright, M.D., president and CEO at MGMA, said in a statement. “Many factors contribute to this problem, chief among them being an increasingly aging population that’s outpacing the supply of chronic care they require. And with a nearly two-fold rise in median compensation for primary care physicians over their specialist counterparts and increased additional incentives, we can now see the premium organizations are placing on primary care physicians’ skills to combat this shortage.” 

Further supporting this trend, the new survey identified meaningful growth in compensation for non-physician providers over the past 10 years. Nurse practitioners saw the largest increase over this period with almost 30 percent growth in total compensation. Primary care physician assistants saw the second-largest median rise in total compensation with a 25 percent increase.

The research also revealed that over the past five years, rises in median compensation varied greatly by state. In two states, median total compensation actually decreased for primary care physicians: Alabama (-9 percent) and New York (-3 percent). Many states saw much larger increases in median total compensation compared to the national rate, the top five being Wyoming (41 percent), Maryland (29 percent), Louisiana (27 percent), Missouri (24 percent) and Mississippi (21 percent).

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Survey: Healthcare Orgs with Multiple RCM Systems Have More Challenges with Denials

May 15, 2018
by Heather Landi
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More than two-thirds of health systems (about 70 percent) use more than one vendor for revenue cycle management, and those organizations that do use more than one solution report larger issues with denials, a recent survey found.

For the survey, Dimensional Insight, an analytics and data management solutions company, collaborated with HIMSS Analytics to poll 117 senior-level decision makers in hospitals and health systems, including CEOs, CIOs, directors of IT and finance and heads of revenue cycle management. The survey examines the state of revenue cycle management, and highlights the difficulty in integrating data, and the impact it is having on revenue collection.

The survey found that more than two-thirds (70.9 percent) of hospitals use their EMR solutions for revenue cycle management. In addition, most hospitals utilize multiple vendors for RCM purposes. This is true of hospitals that leverage their EMR for RCM and those that use other solutions.

The survey also revealed relatively low levels of analytics-based automation in RCM, with 36 percent of hospitals say less than a quarter of their revenue cycle process is automated using analytics. Another 24 percent report that 51 to 75 percent of their RCM process is automated.

As healthcare delivery continues to evolve, hospitals are struggling to make the most of their revenues. The shift to value-based care, increased patient pay, and a flurry of mergers are creating new challenges within the financial ecosystems of health systems. Many organizations are looking for ways to improve their revenue cycle management.

According to the survey respondents, denials continue to be the biggest RCM challenge for health systems today, cited by 76 percent of respondents. Healthcare senior executives also identified revenue integrity (37 percent) and patient pay (34 percent) as top RCM challenges.

Organizations using more than one vendor mostly report bigger issues with denials than those using one RCM solution. Close to 70 percent of health systems using three or more vendor solutions report that denials are their biggest challenge, with only 63 percent of health systems using one vendor solution said denials topped the list of challenges within revenue cycle management. The highest rates of problems with denials (100 percent) were reported by health systems using their EMR plus one or two other solutions.

What’s more, nearly all respondents (98 percent) say collecting data from disparate sources is a challenge for revenue reimbursement. Of them, 65 percent said it was moderately challenging, while 33 percent said it is extremely challenging. The survey also asked health systems which areas within the revenue cycle posed the biggest challenges for collecting data. Performance tracking (27 percent), inability to identify billing errors (25 percent), and keeping up with variances (24 percent) were the top three responses, with another 14 percent citing difficulty monitoring trends.

And, 96 percent of health systems say the way data is collected is a challenge, with 58 percent calling it a moderate issue and 37 percent citing it as a big issue.

The survey drilled down into how disparate data sources can contribute to issues with revenue integrity. About two-thirds of healthcare senior executives cited “lack of interoperability” as an ongoing issue, and the same percentage cited “some systems are left in silos” as an issue that impacts revenue integrity. Another 30 percent of respondents cited another issue—“key stakeholders do not trust the data.”

The survey also examined organizations’ RCM governance processes. A majority of hospitals of all sizes reported that their RCM governance is centralized. Overall, 69 percent of hospitals have centralized RCM governance, with the highest percentage (73 percent) among hospitals with more than 500 beds and the lowest (50 percent) among hospitals with 50 – 100 beds. Overall, 16 percent report having no RCM governance process. The bigger the hospital, the less likely it had no RCM governance in place

The report authors concluded that health systems are struggling with interoperability, and the associated challenges have effects throughout the enterprise. “The survey revealed a patchwork of solutions, an arrangement that does not seem to be working particularly well. In addition to highlighting the challenge of collecting and integrating data from disparate sources, the survey shows a real financial impact. Lack of interoperability does not just affect clinical and operational decisions. It is hurting the bottom line. Health systems need solutions to bring data together and make it useful throughout the entire revenue cycle,” the report states.

 “Many hospitals and health systems are undergoing mergers in hopes of increasing efficiencies. Or they implement several different technologies as band-aids to compensate for the deficiencies of systems,” Fred Powers, president and CEO of Dimensional Insight, said in a statement. “Unfortunately, what they’re finding in many cases is that the different technology systems in place are hard to integrate, and now this is impacting the bottom line.”

 

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Baptist Health South Florida, Navigant Form RCM Joint Venture

April 11, 2018
by Heather Landi
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Coral Gables-based Baptist Health South Florida announced it has signed an operating agreement with Chicago-based Navigant to create a new joint venture entity to provide revenue cycle management (RCM) services to healthcare provider organizations.

The joint venture will initially manage the revenue cycle operations of Baptist Health South Florida, but plans to expand in the future.

Baptist Health South Florida includes 10 hospitals, 50 outpatient and urgent-care facilities, a medical group and 40 physician practices. The not-for-profit has nearly 20,000 employees and more than 3,000 affiliated physicians.

The health system reported total revenue of $2.48 billion in 2017, up 4 percent from $2.38 billion in 2016. However, it had an operating loss of $31.3 million year-over-year. According to Baptist Health South Florida’s 2017 annual financial report, some of the financial pressure stems from late or unpaid bills. Baptist's provision for doubtful accounts increased to $410.1 million in 2017, up 34.3 percent from 2016.

The new company will combine Baptist Health South Florida’s staff and Navigant’s RCM expertise, innovative processes and technology tools. The new entity is expected to be operational in summer 2018.

“With the challenges and changes happening across healthcare, Baptist Health South Florida is focused on remaining financially strong and continuously exploring innovative partnerships,” Ralph Lawson, executive vice president and chief financial officer of Baptist Health South Florida, said in a statement.

“We are committed to improving the patient experience and developing more consumer-friendly systems,” Brian E. Keeley, president and CEO of Baptist Health South Florida, said in a prepared statement. “We selected Navigant, and its subsidiary Navigant Cymetrix, to partner with us because they bring deep industry knowledge, scale, and expertise in process and technology, such as machine learning and artificial intelligence, which will enable us to achieve efficiencies and create a more seamless experience for our patients. Baptist Health has remained fiscally sound, mission-driven, and an innovative leader as we continue to transform the way we deliver care. We believe this new organization will also provide opportunities for team members to grow in their careers and will bring new jobs to our local community.”

Julie Howard, chairman and CEO of Navigant, said, “As healthcare providers transition to a value-based payment system, there is a critical need for innovative solutions. Our move to create a new commercial entity with Baptist Health South Florida is a perfect example of our deep commitment to partnering with our clients, and to identifying unique pathways to add value. By relying on the services provided by this new venture, health systems will have the ability to direct their focus where it is needed most, on their patients and the health of their communities.”

 

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