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October 14, 2019: MGMA survey finds significant increase in regulatory burden on medical practices

Advocacy Statement - October 17, 2019

Medicare Payment Policies

Quality Payment Program

Health Information Technology

Federal Compliance

October 14, 2019
NEW ORLEANS, LA -- On Monday, the Medical Group Management Association (MGMA) released the Annual Regulatory Burden Report at MGMA19 | The Annual Conference. With responses from over 400 medical group practices, the findings from this survey reveal the true impacts of federal regulations on the U.S. healthcare system.

A vast majority (86%) of respondents reported the overall regulatory burden on their medical practice has increased over the past 12 months. Even more respondents (96%) agreed a reduction in regulatory burden would allow their practice to reallocate resources toward patient care.

"Medical Group practices continue to struggle with overwhelming regulatory burden," said Anders Gilberg, Senior Vice President of Government Affairs at MGMA. "Precious time and resources are being diverted from patient care to keep up with the deluge of administrative requirements."

Prior authorization requirements ranked as the top burden for practices with Medicare's Quality Payment Program (QPP) as a close second. Practices continue to face growing challenges with prior authorization, including issues submitting documentation through fax or the health plan’s proprietary web portal, as well as changing medical necessity requirements and appeals processes to meet each health plan’s requirements. As one respondent noted, "During the past year we have added 3 new employees to handle just the prior authorization requirements."

Of the 81% of respondents that participate in the Merit-based Incentive Payment System (MIPS) as part of the QPP, 87% reported that MIPS payment adjustments do not cover the costs of time and resources spent participating in the program.

Not only is the QPP lacking in ROI, 84% of respondents reported that CMS' implementation of value-based payment has increased the regulatory burden on their practice. Over three-fourths of respondents noted that CMS' feedback on MIPS cost and quality measure performance is not useful in reducing costs or improving clinical outcomes.

"Value based reforms have tremendous promise to support physicians who provide high quality, low cost care," said Gilberg. "However, in order to be successful, the government needs to provide medical groups with clinically relevant and actionable patient data. As evidenced by this survey, there’s still much work to be done."

MGMA will use this data to educate the Administration and Congress in our advocacy efforts to reduce burden on medical group practices.

Please find MGMA's Annual Regulatory Burden Report here.

Press Contact:
Terri Pollock
Associate Director, Public Affairs
202.293.3450 x 1351

Medical Group Management Association (MGMA) is the premier association for professionals who lead medical practice. Since 1926, through data, people, insights, and advocacy, MGMA empowers medical group practices to innovate and create meaningful change in healthcare. With a membership of more than 55,000 medical practice administrators, executives, and leaders, MGMA represents more than 15,000 organizations of all sizes, types, structures and specialties that deliver almost half of the healthcare in the United States.

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