Medical groups feel the pressure of regulatory burdens, with the vast majority of physician practices finding it difficult to comply with the Merit-Based Incentive Payment System (MIPS). At the same time, medical groups are facing many other significant health information technology barriers and these challenges are impacting the ability to provide quality patient care, according to a recent survey from the Medical Group Management Association (MGMA).
The survey reflects the responses of 750 group practices, with the largest representation in independent medical practices and in groups with 6 to 20 physicians. The MGMA conducted the 2017 Regulatory Burden Survey to gauge the cost and challenge of complying with federal government regulations and mandates.
In the MGMA survey, medical practices identified the following regulatory issues as “very” or “extremely” burdensome: the Medicare Merit-Based Incentive Payment System (82 percent), lack of national electronic attachment standards (74 percent) and the lack of electronic health record (EHR) interoperability (68 percent).
The survey findings indicate that practices see little clinical benefit in the MIPS program as 80 percent of respondents are very or extremely concerned about the clinical relevance of MIPS to patient care. Further, 73 percent of respondents view MIPS as a government program that does not support their practice’s clinical quality priorities. The vast majority of respondents are participating in MIPS in 2017 and 72 percent plan to exceed the minimum reporting requirements.
“We are a GI single specialty clinic. I can use the specialty measures for the MDs but not the mid-level providers as they don’t apply. I have to have two sets of MIPS requirements and measures. It’s extremely burdensome,” wrote one survey participant.
Survey respondents were asked at what “pace” do they plan to participate in MIPS in 2017 and 41 percent indicated that they would report the full set of MIPS data to aim for a positive payment adjustment and qualification for an exceptional performance bonus in 2019. A large number of practices are unclear about their future performance in advanced APMs, as 40 percent of respondents said they were not sure if they were planning to participate in advanced APMs in 2017.
The survey findings also indicate that practices see the complexity of MIPS as a barrier to success. More than 70 percent of respondents find the MIPS scoring system to be very or extremely complex, and about the same (69 percent) are very or extremely concerned the unclear program guidance will impact their ability to successfully participate in MIPS. One survey respondent wrote, “The resources it will take to comply with MIPS are absurd, and the only thing the program measures is the ability to meet documentation requirements.”
Practices are also concerned with federally-mandated EHR certification requirements and 68 percent of respondents rate the lack of EHR interoperability as very or extremely burdensome. Practices are increasingly dependent on third-party vendors that are not accountable to the same rules and mandates.
Practices also find that non-standardized and onerous transactions drive up the cost of health care. Nearly three quarters of respondents rated the lack of electronic attachments for claims and prior authorization as very or extremely burdensome. What’s more, 93 percent of survey participants support a single provider credentialing source for Medicare, Medicaid and commercial payers in the United States.
“Centralizing and simplifying initial and re-credentialing [of clinicians] would save our practice hundreds of dollars a year,” one survey participant wrote.
More than 80 percent of respondents agree or strongly agree that a reduction in Medicare’s regulatory complexity would allow their practice to reallocate resources toward patient care. “Most of what we do to meet requirements is busy work that has no real impact on patient care,” wrote one survey participant. This research also found the cost of compliance is a significant concern.
Nearly half of respondents report spending more than $40,000 per FTE physician, per year, to comply with federal regulations.
“The magnitude of regulatory demands on physicians forces medical group practices to needlessly focus precious time and resources on administrative tasks instead of patient care,” Halee Fischer-Wright, M.D., president and chief executive officer at MGMA. “MGMA calls for national effort to relieve physician practices from excessive government regulation and looks forward to working with both the Administration and Congress to find meaningful solutions.”