ACO Concerns Top Challenges for Medical Practice Managers

Getting ready for new reimbursement models (such as ACOs) that will mean more financial risk for their physician practices tops the list of the most considerable or extreme challenges practice managers face, a survey from the Medical Group Management Association shows.

Medical practice managers, who work behind the scenes at physician offices handling everything from human resources and business operations to patient care systems and quality management, were asked to rank 44 challenges on a five-point scale for MGMA’s fourth annual Medical Practice Today: What Members Have to Say report.

Operational issues dominate the top five spots while financial, compensation, and recruitment issues round out the top 10:

1.      Preparing for reimbursement models that place a greater share of financial risk on the practice

2.      Participating in the CMS EHR Meaningful Use incentive program

3.      Dealing with rising operating costs

4.      Selecting and implementing a new EHR system

5.      Implementing and/or optimizing an accountable care organization

6.      Managing finances with the uncertainty of Medicare reimbursement rates

7.      Modifying physician compensation formulas to more heavily emphasize quality measures

8.      Recruiting physicians

9.      Negotiating contracts with payers

Several of the challenges at the top of the list this year reflect efforts to implement healthcare reform. Preparing for new reimbursement models grabbed the top spot in the very first year that it appeared in the survey. Implementing an ACO and modifying physician compensation formulas to account for quality measures weren’t mentioned before this year’s survey. 

Liz Johnson, spokesperson for MGMA, explained that the leading challenges reflect the “top-of- mind thinking” by the practice managers. She noted that HIPAA is still a challenge but “it’s not something they think about every day.”

The survey found that the top challenge could differ depending on the practice specialty:

• Cardiology practices ranked managing finances with the uncertainty of Medicare reimbursement rates at their biggest challenge.
• Family practices and multispecialty with primary and specialty care practices placed preparing for reimbursement models that place a greater share of financial risk on the practice at the top of their challenge list.
• Orthopedic surgery practices named implementing and/or optimizing an ACO as their number one challenge.
• OB/GYN practices tapped modifying the physician compensation formula to more heavily emphasize quality measures as their top challenge.

The web-based survey was conducted in January and attracted 1,190 responses.