Eighty-two percent of physician practices willing to explore new Medicare payment models; SGR threat stifles progress

SAN ANTONIO, Oct. 22, 2012 – New research released today by MGMA highlights the impact the financial instability created by a decade of temporary, last-minute congressional reprieves from Medicare sustainable growth rate (SGR) payment cuts has had on physician practices and their ability to participate in new Medicare payment and delivery models. More than 1,000 physician group practices participated in the study. Adobe PDF

Eighteen percent of respondents reported they were currently participating in a new Medicare payment delivery model or demonstration. Practices not participating cited the lack of predictability in current Medicare payments (a 27 percent payment cut is scheduled for Jan. 1) as the main barrier impeding their ability to experiment beyond traditional fee-for-service. Respondents also cited as a barrier the applicability of existing new payment models and demonstration programs to all physician practices, which vary considerably by size, specialty, and location.

Despite the challenges, 82 percent of respondents said they would be likely to explore new payment and delivery models if a degree of stability was restored to the Medicare physician payment system.

"Our research shows that physician practices are willing to engage in new Medicare payment and delivery models that reward high-quality, cost-effective patient care outside of fee-for-service. Now Congress must do its part, repeal the SGR, and provide stability in Medicare payments so physicians can explore and test new patient centered approaches," said Susan Turney, MD, MS, FACP, FACMPE, MGMA president and CEO.

The research also indicates that if payments were stable for five years, a significant majority of practices would be willing to explore alternatives to fee for service such as Medicare ACOs, bundled payments and comprehensive primary care initiatives. As such, The Association continues to call on Congress, as it has for many years, to repeal the SGR and enact a five-year period of Medicare payment stability.

Respondents also shared that the constant uncertainly posed by the SGR has already forced physician practices to reduce clinical staff, delay purchase of clinical equipment or facilities, and cut back on charity care.

"Practices are working diligently to be more patient-centered. These efforts are severely inhibited by the fact that they cannot make sound business decisions and move forward with so much uncertainty," continued Turney.

The study also reflects that, as in previous years, physician practices will be forced to make drastic business and Medicare patient access decisions should a 27 percent cut occur.

MGMA received responses from more than 1,000 group practices in which more than 26,000 physicians practice.

About MGMA  
MGMA is the premier association for professional administrators and leaders of medical group practices. In 2011, members of the Medical Group Management Association (MGMA) and its standard-setting division, the American College of Medical Practice Executives (ACMPE), voted to merge to form a new association. Since 1926, the Association has delivered networking, professional education and resources, political advocacy and certification for medical practice professionals. The Association represents 22,500 members who lead 13,200 organizations nationwide in which some 280,000 physicians provide more than 40 percent of the healthcare services delivered in the United States.

MGMA’s mission is to elevate the performance of medical practice leaders and their organizations by connecting members, building partnerships, setting the standards for certification, advocating for physician practice and providing innovative solutions. MGMA is headquartered in Englewood, Colo., and maintains a government affairs office in Washington, D.C.

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