Practice executives’ satisfaction with insurers driven by accurate and consistent communications
Denver, Colo. Nov. 14, 2012 –New research findings released today by MGMA reveal a strong correlation between members’ overall satisfaction with payers and the accuracy and consistency of payers’ responses to questions. Other drivers of overall satisfaction included the amount of time it takes payers to respond to questions, the promptness of claims payment, and the claims appeals process. Practice executives who responded to the survey were most satisfied with the disclosure of payers’ fee schedules and prompt payment of claims. The study also illustrated wide variation in performance among plans on a number of questions related to administrative transactions.
The annual study measures MGMA member satisfaction with major national health plans including Aetna, Anthem, Cigna, Coventry, Humana, Medicare Part B and United Healthcare. Practice executives provided feedback on their perceptions of payer communications, provider credentialing, contracting, payment policies, rating system transparency, overall satisfaction, and payer willingness to engage in innovative payment models.
“Our members work with payers on a daily basis, and identifying areas of improvement is paramount,” said Susan Turney, MD, MS, FACP, FACMPE, MGMA president and CEO. “It’s mutually beneficial to keep lines of communication open, and for our members and the payer community to cultivate deeper relationships. Ultimately, these interactions may result in less distraction and resource diversion from practices’ primary focus, the needs of their patients.”
Association members also shared feedback regarding partnerships with payers on innovative payment models. When asked for feedback on payers’ engagement in models based on concepts such as accountable care, shared savings, medical homes and payment bundling, a majority of Association members reported that payers were not offering many options that members view as favorable for their practices.
“We welcome opportunities to engage with payers on new payment models and understand that the industry is still developing these options. It’s important for our members not to rush into new models if they aren’t beneficial for their patients and practices. Aligning the incentives for practices, patients and payers will be key for these types of arrangements to be successful moving forward,” Turney said.
Medicare Part B ranked the highest in many categories, such as overall performance, responsiveness to questions, willingness to disclose fee schedules and payment policies, and claims-appeals process. Provider credentialing is the one category in which Medicare is ranked last. The MGMA Government Affairs staff is working closely with Centers for Medicare & Medicaid Services staff to streamline and improve the Medicare enrollment process. MGMA strongly urges Medicare to standardize its provider credentialing with other public and private payers though adoption of the Council for Affordable Quality Healthcare Universal Provider Datasource, which is the industry standard used by commercial payers and state Medicaid programs.
To read the full study results, please visit our website.