Healthcare reform—and all that may or may not come with it—dominated the talk at the Medical Group Management Association’s annual conference and exhibition in New Orleans last week.
Reform on the brain
MGMA conference speakers delve into new law
The need to know how reform will affect medical practices likely drove a 30% increase in paid attendance as 2,800 people came to this year’s conference compared with the 2,150 who attended the annual conference last year in Denver. Including exhibitors and guests, total attendance was about 4,600 this year.
Many speakers offered big-picture takes on reform while others revealed fine details of the Patient Protection and Affordable Care Act just now coming into focus. For example, at one session, attendees were visibly irked to learn of a reform provision mandating practices that order MRI, CT or PET scans to provide patients with a list of 10 alternative sites within a 25-mile radius of the practices’ own imaging services where patients can receive scans.
At a question-and-answer session that opened the conference, MGMA board member Nancy Babbitt, a practice administrator at the Roswell Pediatric Center, Alpharetta, Ga., noted how the reform law bans co-pays for wellness care and asked what will happen to the revenue those payments used to generate. While it may be assumed payers would make up that amount, there’s concern providers would lose income.
Anders Gilberg, MGMA vice president for public and private economic affairs, noted that this issue was not mentioned in implementation rules, so MGMA government affairs staff “talked to the person who wrote the rule,” and he candidly told the MGMA, “We haven’t thought of that.” Gilberg expressed confidence though, that “bright-line guidance” would appear in final rules.
At a panel discussion on healthcare reform, Chip Kahn, president of the Federation of American Hospitals, noted that if Republicans successfully pass legislation to undo reforms, President Barack Obama will veto it. “Healthcare reform is not going to be repealed,” Kahn declared—at least not in the next two years.
So, “there’s going to be a lot of noise,” Kahn said, which may lead many in the healthcare industry to not have full confidence that reform provisions scheduled to kick in during 2014 are really going to happen.
William Jessee, who retires next September and was presiding over his 12th and last annual conference as MGMA president and CEO, responded to Kahn by saying that the reform law merely hastened what was already happening. Noting that most of the law is a “coming attraction,” Jessee said, “Delivery system reform is occurring all over the country already.”
This was something of a common theme at the conference, as well.
During educational sessions on medical homes, speakers from TransforMED, a for-profit consulting arm of the American Academy of Family Physicians that helps medical practices adopt the medical home model, noted how the concept they were promoting could transform healthcare delivery. Chuck Moses, a practice-enhancement facilitator with TransforMED, said medical homes offer the chance for physicians, nurses and administrative staff to work together in ways they never have before to improve quality and lower costs.
“The patient-centered medical home creates a framework for change,” he said.
Another TransforMED presenter, physician assistant Diane Cardwell, agreed and said, “This is an opportunity for primary care to drive things.”
Optimistic words from speakers, however, were contrasted with concern from attendees who feared new accountable care and bundled payment schemes would lead to some sort of penalty against them as a result of patients who express no interest in improving their own health lowering provider quality scores.
Repeal of the Medicare payment formula was another hot issue at the conference, along with preparing for the new ICD-10 billing and diagnostic codes, and implementing and using information technology.
David Blumenthal, the HHS national coordinator for health IT, and Tony Trenkle, director of CMS’ Office of E-health Standards and Services, explained the nuts and bolts of the government’s meaningful-use requirements for health IT incentive payments and what changes electronic healthcare-record adoption are expected to bring.
William Crounse, Microsoft’s senior director for worldwide health, discussed the latest IT innovations in a keynote speech while noting how the U.S. still lagged behind other industrial nations in IT implementation. He said he was “offended” by U.S. hospitals on tight budgets spending $150 million on EHR systems while hospitals in other countries were customizing off-the-shelf products that can “run circles around” what is used here for much less money.
The conference closed on an inspirational note from Tulane University President Scott Cowen, who told how his institution has been rebuilt after the disaster of Hurricane Katrina five years ago. Cowen said Tulane’s School of Medicine received an application from roughly one out of every four students applying for medical school this fall, and how the makeshift clinic it opened outside the Harrah’s New Orleans Hotel & Casino led to the creation of a community network of 89 primary-care clinics that he said was the highest density of medical homes in the nation.
“Our institution has not only recovered, we’re thriving,” Cowen said. “In a bizarre way, Katrina made us a better and stronger institution.”
—With Gregg Blesch, Maureen McKinney and David Burda
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