Ongoing hurdles in scheduling, reimbursement, and collections compound difficulties for a healthcare industry already under stress a recent study says.
Medical Group Management Association (MGMA) recently released a report detailing new benchmarks related to the adoption rate of value-based reimbursement and other hurdles revenue cycles frequently face.
The report found that the average rate of value-based care only accounts for approximately 5.5% to 14.74% of revenue, with primary care and surgical specialties reporting lower revenue shares from value-based contracts in 2021 and nonsurgical specialties attributing 14.74% of total medical revenue to value-based contracts, the report said.
Other aspects of the revenue cycle were also studied in the report.
According to the MGMA, the return of patient volume in 2021 led to shifts in appointment scheduling benchmarks, as higher demand for care saw no-show rates hold steady and an uptick in cancellation rates which has put a large burden on revenue cycle staff.
Overall patient portal usage improved from 2020 to 2021, with a significant increase in patient logins, the MGMA found.
The study also found that increased care volumes, claim denials, and staffing shortages combined to spur concerning shifts in billing and collections benchmarks, as copay collections at time of service declined and charge-posting lag times increased for specialist practices.
Also, the percentage of claims denied on the first submission doubled across primary care, nonsurgical, and surgical specialties, the study noted.
“The medical workforce is grappling with burnout, staffing declines, decades-high inflation, operational challenges and a dynamic reimbursement environment that affects providers across the board,” said Dr. Halee Fischer-Wright, MD, MMM, FAAP, FACMPE, president and chief executive officer of MGMA.
“This report reveals how addressing scheduling errors and billing denials could help relieve the financial burden on health groups, moving them toward value-based care that promotes the welfare of physicians, staff, and patients.”
The report includes data from more than 2,300 organizations across multiple specialties and practice types.
Amanda Norris is the Director of Content for HealthLeaders.