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MGMA: Medicare Part B Tops Payer Rankings

 |  By jfellows@healthleadersmedia.com  
   November 15, 2012

Put another point on the board for HHS. 

Medicare Part B remains the highest ranked payer among executives of physician practices, a Medical Group Management Association survey finds.

MGMA released its fifth annual survey of group practice attitudes toward their interactions with the country's seven largest payers: Aetna, Anthem, Cigna, Coventry, Humana, Medicare Part B, and United Healthcare.  Allison Brennan, senior advocacy advisor for MGMA's government affairs says Medicare Part B has consistently scored higher than the other six.

"Medicare might not always be the best payer, but their policies are easier to find, easier to understand, and the fee schedule and the regulations are a bit more transparent," says Brennan.

The overall satisfaction ranking this year remains unchanged from last year. The payers that scored highest on overall satisfaction with physician practice executives are:

  1. Medicare Part B
  2. Cigna
  3. Aetna

Medicare Part B led in satisfaction for most of the 13-question survey, which gauged communication with payers, contracting, payment policies, transparency, and overall satisfaction. It fell below to the bottom of the pack, however, in the area of provider credentialing. There it earned a score of 2.90 based on a 1–5 scale with 1=completely dissatisfied and 5=completely satisfied.

Cigna, the other payer consistently ranked at the top on overall satisfaction in most areas, used to be a Part B contractor until it sold its CGS unit to Blue Cross Blue Shield of South Carolina last year.

In a statement, Mark Slitt, spokesman for Cigna said, "We appreciate report cards like this because they point out where we're doing well, and where we have opportunities to improve the experience that health care professionals and their professional staff have with Cigna."

MGMA provides all payers with the survey results as well as the comments that responders provided that are specific to the payer's organization.  Nearly 800 physician practice professionals answered the survey, which is down from close to 1,000 in recent years.

Brennan attributed the lower response rate to the increased demands on practices.  "There is growing frustration with the complexity in our healthcare system, and a lot of our members are frustrated by that complexity and the red tape," says Brennan.

MGMA added two new questions this year on innovative payment models.

"These things really are gaining more traction and increased focus in the industry as a whole so we wanted to see what our members' perceptions are of working with payers on these types of models and whether or not they're beneficial to practices," says Brennan.

This part of the survey is where every payer scored badly. On the question that asked about the willingness of a payer to engage in a new model such as ACO, medical home or payment bundling, MGMA members scored each one as being somewhere between completely and moderately unfavorable.

Brennan says members are in no rush to join the new reimbursement models still largely in the development stage, but the survey can help payers know what physician practices are thinking. "For payers... some of the feedback that will be helpful to them is to understand that practices have to view any type of innovative payment model as being favorable for the practice."

"This is a perception survey, so we may get payers who say, 'What we are providing absolutely is 100% beneficial,' and that may be the case but what they need to understand is that if it is not perceived as being beneficial for the practice that's going to be a hindrance for the payers and for practices moving forward with these types of new models."

There was one bright spot for all the payers. All seven scored highest in the area of how promptly claims are paid.

Still, Brennan says, there is work to be done in payer communication.

"What we really saw as the biggest predictors of overall satisfaction were the payer's abilities to answer questions quickly, accurately, and consistently."

She says a lot of MGMA members commented on long, drawn-out automated processes, getting to the right person, and offshore calling centers, though on that last point there has been some improvement.

"A couple of payers [are] bringing call centers back to the U.S. rather than continuing to have them located in other countries. There were a lot of complaints about dealing with language barriers and communication issues, so that is something that we've been pleased to see," says Brennan.

United Healthcare added call center jobs to its locations in Miami and Buffalo earlier this year.

The relationship between physician practices and payers isn't rosy, but Brennan hopes the survey will open the door to more dialogue between the two groups.

"We want to work with them to improve these relationships. There is a lot of frustration out there and there are a lot of areas we can work together on," says Brennan.

Jacqueline Fellows is a contributing writer at HealthLeaders Media.

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