MGMA Survey: Regulatory Burden Getting Worse

Nov. 2, 2021
Asked if positive payment adjustments in the MIPS program cover the costs of time and resources spent preparing for and reporting under the program, 93 percent of survey respondents said no

Each year, the Medical Group Management Association (MGMA) surveys members about their impressions of the impact of regulatory burden on their practices. The quality payment programs of the Centers for Medicare and Medicaid Services (CMS) remain highly unpopular with group practices.

MGMA asks members about issues such as quality measurement reporting and completing prior authorization requirements, The organization said it uses the data gathered in the report to educate Congress and the Administration about obstacles to delivering high-quality patient care.

The survey includes responses from executives representing more than 400 group practices. Seventy percent of respondents are in practices with fewer than 20 physicians and 10 percent are in practices with more than 100 physicians. More than 80 percent of respondents are in independent practices.

Ninety-one percent of respondents said overall regulatory burden has increased in the past year, while 8 percent said it has been unchanged, and 1 percent said it has decreased.

Asked if a reduction in regulatory burden would allow their practices to reallocate resources toward patient care, 95 percent said yes.

MGMA notes that administrative requirements, such as prior authorization, not only delay patient care but also increase provider costs and burden. Eighty-eight percent of respondents described prior authorization as very or extremely burdensome.

Another issue the report deals with is the impact of consolidation. Seventy-five percent of medical groups indicate that increasing regulatory burden has been a major contributor to the increasing rate of consolidation in healthcare, MGMA said. Ninety-two percent of respondents said they think consolidation is increasing.  Asked how they would describe the overall impact of consolidation on the U.S. healthcare system, 72 percent said negative.

The Merit-based Incentive Payment System (MIPS), which 73 percent of respondents participate in, remains unpopular.  Asked if positive payment adjustments cover the costs of time and resources spent preparing for and reporting under the program, 93 percent said no.

In fact, 79 percent of respondents reported that the CMS implementation of value-based payment reforms has increased the regulatory burden on their practice, while 70 percent said they believe value-based care programs have not improved quality of care for patients.

Advanced Alternative Payment Models (APMs) are not much more popular than MIPS. Asked if Medicare offer an Advanced APM that is clinically relevant to their practice,  80 percent said no.

But asked if their practice would be interested in participating in an APM if it was clinically relevant and aligned with their quality goals, 63 percent said yes.

MGMA said it has expressed concerns to the Center for Medicare and Medicaid Innovation (CMMI) in response to its recent proposal to create a more streamlined and condensed portfolio of APMs. “There is no single approach to APMs that will work for all practices or specialties. Different specialties are responsible for the provision of different types of care, and thus there is no one-size-fits-all approach to APM design. Within the current portfolio of APM offerings, a majority of MGMA practices do not have a clinically appropriate model in which to participate,” MGMA said. “Therefore, consolidating the CMMI portfolio of APMs, focusing on primary care and episodes of care, will continue to make widespread APM participation a challenge.”

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