Medical Group Practices Struggle with MIPS, According to New MGMA Report

On Monday, the Medical Group Management Association (MGMA) released the Annual Regulatory Burden Report at their Annual Conference. With responses from over 400 medical group practices, the findings from their survey reveal the impact of federal regulations on physician practices and medical groups.

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.”

Of the 81% of respondents that participate in the Merit-based Incentive Payment System (MIPS) as part of Medicare’s Quality Payment Program (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.

Joy Rios, Co-Founder of Chirpy Bird Health IT Consulting and author of 2019 MIPS Manual – A Comprehensive Guide to MACRA and the CMS Merit Based Incentive Payment System sat down with Healthcare Scene to discuss the MGMA Report.

“We agree with the MGMA survey data,” said Rios. “Our anecdotal evidence is that administrators feel terribly burdened by MIPS/MACRA.”

Rios points out that the first two years of MIPS were transition years and the program, by design, is budget neutral. Thus, by easing the financial penalties during this transition, CMS did not have a lot of money available to reward top performers.

“As the industry drives toward sophisticated two-sided financial risk models, MIPS remains the lowest common denominator in value-based care,” explained Rios. “As an example, if two-sided APMs are the major leagues, then MIPS is a AAA league. Value-based care initiatives are not a fad. Just like with any major league sport, to be successful, you’ve got to level up your skills. It requires an understanding of the game, lots of practice, and execution when it’s game time. These are the steps that will ultimately be what pioneers a pathway to MIPS success.”

“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.”

“The unfortunate truth is we’re in a middle of a huge change,” continued Rios. “That in and of itself is uncomfortable for a lot of people. It’s going to be awhile before the average practice feel like they’ve “got MIPS covered.” However, on the flip side, we know from experience that with the right strategy and expertise, it is absolutely possible to succeed in MIPS.”

About the author

Colin Hung

Colin Hung

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.