New MGMA research on member satisfaction with payers reflects importance of transparent, standardized administrative processes
Medicare Part B performs well against private payers
DENVER, Colo., Oct. 12, 2009 – In results released today by the Medical Group Management Association (MGMA) from its study of MGMA member satisfaction with major health plans, respondents were most satisfied with the disclosure of payers' fee schedules and prompt payment of claims. Administrative processes that were standardized and transparent also produced high satisfaction scores. The study reflected several common themes, as well as wide variation in performance among plans on a number of questions related to administrative transactions. The study did not address payment levels.
MGMA members expressed a high level of satisfaction with the major private health plans regarding their provider credentialing processes, but citied dissatisfaction with this process for Medicare. "We believe this is result of Medicare's refusal to participate in the standardized physician credentialing system (CAQH Universal Provider Datasource) that is widely used in the private sector," said William F. Jessee, MD FACMPE, MGMA president CEO. "Our members appreciate payers that provide clear, consistent processes, especially processes that are based on industry wide standards."
MGMA members gave Medicare Part B highest marks on questions related to responsiveness, transparency, prompt payment and overall satisfaction with general administrative functions. "Despite the fact that Medicare consistently underpays and places member practices in an increasingly difficult financial situation – with a looming 21 percent cut to physician payments – MGMA members were positive about the standardized and predicable nature of how the program is administered," said Jessee.
"What makes this study unique is the direct interaction MGMA members and their staffs have with health plans on a daily basis," he continued. "MGMA's diverse membership comprises practice administrators, CEOs, physicians in management, board members and numerous other practice management professionals. They work in medical practices and ambulatory care organizations of all sizes and types, including integrated systems and hospital- and medical school-affiliated practices.
"MGMA represents group practices that are major suppliers of physician services for these health plans. As such, we look forward to payers reflecting on these results and working with us to create solutions in areas identified as needing improvement. The results speak for themselves. It is our goal that all plans – public and private – achieve positive satisfaction scores from MGMA members on all of these key administrative functions."
Results can be viewed by visiting www.mgma.com/payerperformance09
MGMA is the premier membership association for professional administrators and leaders of medical group practices. Since 1926, MGMA has delivered networking, professional education and resources, and political advocacy for medical practice management. Today, MGMA's 22,500 members lead 13,700 organizations nationwide in which some 275,000 physicians provide more than 40 percent of the health care services delivered in the United States.
MGMA's mission is to continually improve the performance of medical group practice professionals and the organizations they represent. MGMA promotes the group practice model as the optimal framework for health care delivery, assisting group practices in providing efficient, safe, patient-focused and affordable care. MGMA is headquartered in Englewood, Colo., and maintains a government affairs office in Washington, D.C.