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    Rising expenses and the end of some pandemic-era flexibilities have many medical group leaders focused on boosting productivity and revenues to continue their post-COVID-19 recovery — and new polling from MGMA Stat suggests it’s still a long road ahead amid staffing shortages and other factors holding providers back.

    MGMA Stat: 48% of medical groups are on target for their expected productivity for the year. October 10, 2023 MGMA Stat poll, 353 responses

    Just more than two-thirds (67%) of medical groups report their productivity is exceeding (19%) or on target (48%) to reach their expectations for 2023, while one-third (33%) report they are below expected productivity levels, according to an Oct. 10, 2023, MGMA Stat poll with 353 applicable responses.

    These figures are similar to a similar poll from November 2022 that found 65% of groups reported having exceeded (29%) or been on target (36%) for 2022 productivity goals, with 36% of groups at the time noting they were below expected productivity. [Note: The 2022 results did not equal 100% due to rounding.]

    The 10-percentage-point drop in the share of medical groups exceeding their productivity goals over the past year gives some insight into the intensity of impacts from staffing shortages — recently ranked as the top priority to address by medical group leaders in a Sept. 26, 2023 MGMA Stat poll — and other challenges facing practices.

    What’s holding practices back

    It’s no secret that having the right people — and enough of them — to operate a medical practice with optimized schedules is still the biggest roadblock to higher productivity, as noted in an April 2023 poll that ranked the issue of staffing firmly ahead of other challenges such as administrative burdens, patient scheduling and more.

    As detailed by David N. Gans, MSHA, FACMPE, in his July 2023 Data Mine article, MGMA DataDive benchmarks from four key specialties — noninvasive cardiology, family medicine (without OB), general orthopedic surgery and general surgery — showed substantial work RVU (wRVU) decreases in physician- and hospital-owned practices in the first year of the COVID-19 pandemic, followed by some recovery in 2021 and increases again in 2022. However, the limited gains have constricted the ability for physician earnings to rise at rates that keep up with the extraordinary inflationary pressures from rising expenses across the economy for healthcare organizations.

    For example: The growth in median total compensation for primary care physicians doubled from 2021 (2.13%) to 2022 (4.41%), according to MGMA DataDive Provider Compensation, while inflation — measured by the Bureau of Labor Statistics’ Consumer Price Index (CPI) — stood at 7% and 6.5%, respectively.

    When medical group leaders responding to this week’s poll were asked about the biggest factors holding back productivity, staffing shortages and the lower volumes associated remained the most frequent responses.

    “We just can’t seem to hire and keep staff,” one practice leader told MGMA. “We are not alone in this problem, but it is very frustrating. We have had to cut hours.” Another practice leader in neurosurgery pointed to ongoing coverage issues with third-party anesthesia groups contracted by their hospital having a limiting impact on operating room productivity.

    The effects of the Great Resignation in recent years are still being felt at multiple positions, as revealed in the 2023 MGMA DataDive Practice Operations report:

    • Front office support staff had a 40% turnover rate in the single specialty aggregate of primary care, nonsurgical and surgical single specialty practice data.
    • Single specialty aggregate data put turnover for business operations support staff at 33.3% in 2022.
    • The same measures for physicians and advanced practice providers (APPs) in 2022 were 16.67% and 25%, respectively.

    But lack of personnel is not solely to blame, according to respondents: Several noted that they have encountered technology issues that disrupted their operations and held back productivity, including EHR changes and impacts from difficulties with new billing or revenue cycle management platforms.

    For some medical groups, the impacts of inflation on patients’ pocketbooks have led to less discretionary income and lower utilization of optional and ancillary services.

    What’s working well

    Just as staffing was the biggest problem for those underperforming their expected productivity levels, the same issue was a frequent cause for celebration among those who were on track to meet or are exceeding their goals.

    Several respondents noted that they have implemented incentives to re-fill their officers with providers and staff, sometimes overstaffing to prepare for turnover without disrupting volumes or access. Some of these medical group leaders acknowledged that it was a balance of market salary surveys and compensation plan revisions to be more competitive for providers and staff, but others managed their improvements through other means:

    • Improving follow-up on new patient referrals and closer monitoring of prior authorizations
    • New advertising campaigns to grow patients to keep schedules full
    • Improving data analytics to share performance with providers and staff and set goals for visit volumes
    • Concentration on increasing physicals and wellness visits
    • New hybrid working arrangements that enabled broader hiring of work-from-home roles without crowding existing office/clinic space
    • Scheduling block updates to create more availability.

    Additionally, several poll respondents simply noted that patients are returning in droves to their practices and that there is no shortage of demand for care.

    Learn more at #MGMALeaders

    We’re just days away from the start of the 2023 Leaders Conference, Oct. 22-25 in Nashville. If you’re joining us and want to come away with practical steps to address staffing shortages, be sure to mark these sessions on your event calendar:

    Join MGMA Stat

    We depend on a strong feedback loop with you to provide great resources, education and advocacy for medical group leaders. To be part of this effort, sign up for MGMA Stat and make your voice heard in our weekly polls. Sign up by texting “STAT” to 33550 or visit Polls will be sent to your phone via text message.

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