Report: Medicare reimbursement tops daily struggle for medical pros

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Managing finances with the uncertainty of Medicare reimbursement rates took the top worry among 1,252 medical practice professionals participating in a survey from Medical Group Management Association-American College of Medical Practice Executives (MGMA-ACMPE) on their daily struggles.

The organization invited members via email to participate in a web-based questionnaire about their practices. Members rated 54 issues and identified which challenges were most applicable and intense to their daily work.

Following Medicare reimbursement worries, the Englewood, Colo.-based MGMA noted that preparing for reimbursement models that place a greater share of financial risk on the practice was the next top concern.

"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, president and CEO of MGMA-ACMPE in a prepared statement. "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."

Other top concerns included:

  • Preparing for the transition to ICD-10 diagnosis coding
  • Dealing with rising operating costs
  • Participating in the Centers for Medicare & Medicaid Services' EHR meaningful use incentive program

Challenges for physician-owned medical groups and groups owned by hospitals or integrated delivery systems (IDSs) differed slightly, according to the report. “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 IDS- or hospital-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 (PCMH), and dealing with the commercial-payor physician credentialing process were also cited as greater challenges for hospital-owned groups. 

"The healthcare environment is increasingly complex to navigate," Turney concluded. "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."