MGMA: Regulatory Burden on Medical Groups Excessive

Debra Beaulieu, August 11, 2017

One in five groups participating in MIPS plan to report the minimum amount of data to avoid a penalty in 2019.

Nearly half (49%) of medical practices surveyed by the Medical Group Management Association (MGMA) spent at least $40,000 per physician FTE to comply with federal regulations in 2016. And that’s just the tip of the regulatory-burden iceberg, suggest the responses from 750 group practices across the country.

Related: Fewer Than 1 in 4 Docs Prepared for MACRA Requirements

Respondents, most of whom have 6–20 physicians, rated the following regulatory issues as “very” or “extremely” burdensome:

  • The Medicare Merit-Based Incentive Payment System (MIPS) (82%)
  • Lack of national electronic attachment standards (74%)
  • Payer audits and appeals (69%)
  • Lack of EHR interoperability (68%)

Within the MIPS program, medical groups cited clinical relevance (80%) as their top concern.

Meanwhile, 73% said they would characterize Medicare’s implementation of MIPS to date as, “a government program that does not support our practice’s clinical priorities.” The same percentage rated the MIPS scoring process as “very or extremely complex.”

Related: MACRA 2018 Proposed Rule Reflects New CMS Flexibility

Nonetheless, 84% of groups surveyed said they were participating in MIPS in 2017, with 41% planning to report the full set of MIPS data in hopes of a positive payment adjustment and to qualify for a performance bonus in 2019. Twenty percent said they intend to report the minimum amount of data to avoid a penalty in 2019.

When asked about their plans regarding Medicare’s Advanced Alternative Payment Model (APM), the largest group (40%) reported being unsure of whether they’d participate as an Advanced APM in 2017, while 13% reported they would participate as part of the Comprehensive Primary Care Plus (CPC+) program.

“The magnitude of regulatory demands on physicians forces medical group practices to needlessly focus precious time and resources on administrative tasks instead of patient care,” said Dr. Halee Fischer-Wright, MD, MMM, FAAP, CMPE, president and chief executive officer at MGMA.

“MGMA calls for national effort to relieve physician practices from excessive government regulation and looks forward to working with both the Administration and Congress to find meaningful solutions,” she said.

Debra Beaulieu

Debra Beaulieu is the Senior Physicians Editor for HealthLeaders Media.

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