News & Insights

MGMA welcomes incoming Board Chair Todd D. Grages

News Article - 10.4.18

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Christian Green MA
This month, Todd D. Grages, MSBA, FACMPE, FACHE, president and chief executive officer, Methodist Physicians Clinic, Omaha, Neb., assumes the role of MGMA Board Chair, succeeding outgoing Board Chair Yvette T. Doran, MBA, FACMPE.
Grages, who has been a CMPE for 20 years and an ACMPE Fellow for 18 years, holds a bachelor of arts degree in chemistry from Concordia College, Moorhead, Minn., and a master of science degree in business administration from Boston University.
Grages has been Vice Chair for the past year and a member of the Board of Directors since 2014, shortly after the merger with the American College of Medical Practice Executives (ACMPE). “I came on when there was a lot of uncertainty,” says Grages. “Anytime you take two organizations and put them together and come up with a unified board and start working on things, there’s a lot of concern from members and board members about the direction of the organization.”
During his time on the Board of Directors, Grages has been an integral part of the success and progress MGMA has achieved. “The stability we’ve been able to create by growing the organization, growing awareness nationally, whether it’s through our Government Affairs [team] or strictly through the medical practice . . . and being the go-to source, especially for data in managing practices,” have been some of the highlights, according to Grages.
This progress has been reflected in increased participation throughout the Association. “In every aspect of MGMA, we have more individuals engaged with helping us improve the organization and providing a high-quality healthcare association,” notes Grages.
Like many MGMA members, throughout his career Grages has taken advantage of all the resources the Association offers. “It’s been my source for professional development, networking, building relationships . . . and providing resources through survey data that allows me to be transparent with my physicians and work toward improving practice performance, not only from a clinical standpoint, but a quality, cost and patient experience standpoint as well.”
Methodist Physicians Clinic is a multispecialty medical group in eastern Nebraska and southwestern Iowa. The group has approximately 350 providers, a panel size of more than  350,000 patients and performs approximately 700,000 office visits annually at its clinics.
Methodist stands out from other practices as its president and CEO has a nonclinical background, yet the medical group is more physician-led than most medical groups. In fact, it doesn’t have a chief medical officer. Instead, eight physicians elected by their peers meet once a month to lead the organization strategically. A physician quality committee with physician representatives from each of the medical group’s 25 sites also meets once a month to lead the medical group in its value-based initiatives. The remaining leaders are decentralized to the sites and/or specialties giving physicians the opportunity to run their practices as if they were physician owned.

“A couple of things that have been most important through this process are our provider satisfaction and physicians taking control of their practices,” says Grages. “Who else is in a better position to make decisions about their practices than the physicians themselves?”
“We’ve hit the best practice benchmark for provider satisfaction since 2012 and our primary care physician satisfaction is off the charts,” says Grages. “Methodist also boasts administrative costs that produce results at the 10th percentile based on MGMA survey data.”
Methodist also boasts an average work volume of its established physicians at the 72nd percentile of the 2018 MGMA Data Dive Provider Compensation report. “It’s all about creating an environment where physicians succeed and fail on their own merits. It’s also about transparency in our initiatives,” says Grages. “If it’s important enough for us to measure, we provide the information to all physicians by site by physician so all physicians and staff can see others performance. Transparency has had a significant impact on improving performance.”
The other key aspect of Methodist’s success is providing its physicians with the resources to be successful. As Grages notes, these resources include clinical space, staff and IT. “We also provide our primary care with health coaches and advance clinical nurses with cardiac and pulmonary experience to create a team-based care culture in which the team works together to ensure better patient outcomes,” says Grages.
It has also been a key factor in helping Methodist create several value-based initiatives, including system-wide:
  • Patient-centered medical home model
  • Patient experience program
  • Cost committee evaluating opportunities to reduce the cost of care
  • Heart and lung wellness centers
  • Skilled nursing facility program (SNF)
  • Clinical staff incentive program which provides quarterly bonuses to staff exceeding performance measures in quality, patient experience and access
  • Advanced case management for high-risk patients
 This model shift from episodic care to holistic, team-based care has produced outstanding results, as Methodist has achieved Patient-Centered Medical Home Level 3 recognition from the National Committee for Quality Assurance (NCQA) since 2012. Some of the most compelling statistics include:
  • Top 5% nationally in quality outcome
  • Top 5% nationally in provider satisfaction
  • 10th percentile in administrative costs, according to the 2018 MGMA DataDive Cost and Revenue report
  • SNF program boasts a readmission rate of less than 6%, compared to national average over 20%
  • 6% above the 5-star rating for hypertension/high blood pressure, with 100% of clinics above 5-star rating
  • 5% above the 5-star rating for diabetic control, with 100% of clinics above 5-star rating
  • In a market that has a small percentage of value-based care plans, Methodist received more than $5.6 million in quality incentives, gain sharing and care coordination from payers
Moving forward as Board Chair, Grages will continue to help MGMA achieve success and improve awareness by working closely with the Board of Directors to identify opportunities for sustained growth and stability. “MGMA will have many opportunities to grow, develop and move forward to be the most relevant, influential and powerful healthcare association in the nation,” says Grages.

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About the Author

Christian Green
Christian Green MA
MGMA Writer/Editor MGMA