The Medical Group Management Association used its annual conference last week in Philadelphia to stump for changes in the way doctors are reimbursed.
MGMA President and Chief Executive Officer William Jessee declared that Medicare physician payment is No. 1 on our advocacy agenda, and he urged conference attendees to e-mail their members of Congress to express their displeasure with the cuts, expected to be a 9.9% reduction under the current approach.
Jessee noted how the issue has the support of many in Congress, but the proper legislative vehicle to address the problems hasnt been developed and now lawmakers are balking at anything that will increase spending that doesnt also include a new funding source.
At an Oct. 29 news briefing, Jessee cited an MGMA survey released in September that listed some of the economic consequences of a 9.9% cut, including medical groups having to reduce such things as employee healthcare benefits, information technology investments, the number of Medicare patients seen by medical groups, and clinical and administrative staff.
Two approaches to dealing with the gloomy economic forecast touted at the conferences education sessions were expanding the use of physician assistants and nurse practitioners and converting to a cash-only practice.
Along with providing economic value, Ron Nelson, president of Fremont, Mich.-based consultancy Health Services Associates, predicted the use of nonphysician healthcare providers will increase along with the rise of pay-for-performance programs and patient satisfaction as a quality indicator.
Nelson, a practicing physician assistant, said that such providers can help manage the preventive care and disease-management tasks mandated in many pay-for-performance plans, and patients will appreciate decreased wait times and improved access to services, which could ultimately lead to fewer emergency department visits.
But because of the labyrinth of laws regulating payment and use of nonphysician providers, Nelson advised attendees to seek out professionals specializing in these arcane matters before drafting or signing contracts. Having a JD, CPA or MBA doesnt make you an expert in this area, he said.
Meanwhile, David Albenberg described his retainer-based, mostly insurance-free primary-care practicecalled Access Healthcareas an experiment. But, he added that its an experiment that has been working for him since he opened his doors in March 2003. He has offices in Charleston and Mount Pleasant, S.C.
Previously, he was an integrated practice association employee taking on increased risks and debts and lower salary. He said he now earns an annual take-home pay of $144,131 while only seeing about 10.25 patients a day. It wasnt easy, but Albenberg said that, if its not a painful change, it isnt enough to put you out of your present misery.
Despite the misery Jessee predicted from a Medicare payment cut, he also painted a strong financial picture for MGMA. For the past fiscal year, which ended in June, MGMA saw gross revenue of $26.3 million and net income of almost $2.9 million.
About 5,200 people were at the conference, including 2,620 paid attendees and representatives from 377 companies in the exhibition hall. The number of paid attendees was down from the 3,608 at the 2006 MGMA conference in Las Vegas and the 2,832 at the 2005 event in Nashville. The number of exhibitors was a record high though. Next years event is scheduled for Oct. 19-22 in San Diego.