Healthcare leaders from across the nation are renewing calls for the Centers for Medicaid and Medicare Services (CMS) to shorten the meaningful use (MU) reporting period in 2015 and provide more program flexibility, citing concerns with lower-than-expected Medicare numbers and continued reports detailing nationwide difficulty in meeting federal guidelines for electronic health records (EHR) requirements.
According to newly released CMS numbers, less than 17 percent of the nation’s hospitals have demonstrated Stage 2 capabilities. Further, less than 38 percent of eligible hospitals (EHs) and critical access hospitals (CAHs) have met either stage of meaningful use in 2014, highlighting the difficulty of program requirements and foretelling continued struggles in 2015. And while eligible professionals (EPs) have until the end of February to report their progress, only 2 percent have demonstrated Stage 2 capabilities thus far.
Officials from the American Medical Association (AMA), College of Healthcare Information Management Executives (CHIME), Healthcare Information and Management Systems Society (HIMSS) and Medical Group Management Association (MGMA) called the results disappointing, yet predictable.
“Meaningful use participation data released today have validated the concerns of providers and IT leaders. These numbers continue to underscore the need for a sensible glide-path in 2015,” said CHIME president and CEO Russell P. Branzell, FCHIME, CHCIO. “Providers have struggled mightily in 2014, in many instances for reasons beyond their control. If nothing is done to help them get back on track in 2015, we will continue to see growing dissatisfaction with EHRs and disenchantment with meaningful use.”
CMS data required by Congress indicate that more than 3,900 hospitals must meet Stage 2 measures and objectives in 2015 and more than 260,000 eligible professionals (EPs) will need to be similarly positioned by January 1, 2015. Given the low attestation data for 2014 and the tremendous number of providers required, but likely unable to fulfill, Stage 2 for a full 365-days in 2015, healthcare leaders have pressed for a shortened reporting period in 2015, mirroring the policy of 2014.
MGMA announced that Debra J. Wiggs, FACMPE, founder and chief executive officer (CEO), Trinity Management Solutions, Bellingham, Wash., will serve as Board chair of MGMA. Wiggs has provided executive leadership in medical group management roles for private, public and hospital-based organizations in both rural and metropolitan settings. She served as vice president of physician services, St. Joseph Regional Medical Center, Lewiston, Idaho, from 2011 to 2014.
Stephen A. Dickens, JD, FACMPE, senior consultant of organizational dynamics, State Volunteer Mutual Insurance Co., Brentwood, Tenn., will continue to serve as immediate past chair and member of the MGMA Executive Committee. Mickey Smith, FACMPE, FACHE, FHFMA, chief executive officer, Oak Hill Hospital, Brooksville, Fla., will serve as MGMA Board vice chair. Ronald W. Holder Jr., MHA, FACMPE, vice president, medical specialties – Central Texas, Baylor Scott & White Health, Temple, Texas, will serve as the finance and audit chair of the MGMA Board of Directors. Jerard Jensen, MGMA interim president and CEO, will also serve on the MGMA Board of Directors.
New members appointed to the MGMA Board of Directors include:
• Yvette T. Doran, FACMPE, corporate director, Physician Operations Division II, Community Health Systems Professional Services Corporation, Franklin, Tenn.
• Todd Grages, FACMPE, FACHE, president, Methodist Physicians Clinic, Omaha, Neb.
• William R. Hambsh, CPA, CMPE, chief executive officer, North Florida Women’s Care, Tallahassee
Organizations deemed “better-performing medical practices” by the MGMA Performance and Practices of Successful Medical Groups: 2014 Report Based on 2013 Data excelled in four performance-management categories: profitability and cost management; productivity, capacity and staffing; accounts receivable and collections; and patient satisfaction. The practices designated as better performers in these areas were culled from 2,518 respondents to the MGMA 2014 Cost Survey.
Profitability and cost management
In this category, better-performing multispecialty practices reported a lower total operating cost as a percent of total medical revenue than other groups (55.91 percent compared to 70.42 percent).
“Medical practices that actively monitor their operating costs and use benchmarking data and tools to assess their performance are positioned for long-term success and sustainability,” said Todd Evenson, MGMA vice president of data solutions and consulting services.
Accounts receivable and collections
Medical groups designated as better performing reported collecting receivables more quickly than their peers. Better-performing multispecialty practices indicated that only 8.05 percent of their total accounts receivable (A/R) was in the 120-plus day category.
Evenson asserts that “this metric is a strong indicator of healthy financial management, and better-performing medical practices have the right procedures and processes in place to do this efficiently.”
Productivity, capacity and staffing
Better-performing medical practices in this area implemented operational efficiencies to ensure strong provider productivity, including employing non-physician providers such as physician assistants, nurse practitioners and certified nurse anesthetists, as well as ensuring efficient patient flow throughout the practice. For instance, better-performing multispecialty practices indicated that they leverage work from clinical support staff at a higher ratio, a reported 6.33 clinical support staff per full-time-equivalent (FTE) physician versus 4.31 in other groups.
More than 82 percent of physician group practices responding to the MGMA Physician Practice Assessment: Medicare Quality Reporting Programs* research reported they actively engage in internal processes to improve clinical quality for the patients they serve. Despite this focus, practices were heavily critical of Medicare’s physician quality reporting programs and their impact on patients and practices. More than 83 percent of physician practices stated they did not believe current Medicare physician quality reporting programs enhanced their physicians’ ability to provide high-quality patient care.
In addition to the lack of effectiveness, physician practices reported significant challenges in complying with Medicare quality reporting requirements. More than 70 percent rated Medicare’s quality reporting requirements as “very” or “extremely” complex. In addition, a significant majority of respondents indicated these programs negatively affected practice efficiency, support staff time, and clinician morale.
Next year, 2015, will be a critical year for medical group practices participating under three main Medicare Part B physician quality reporting programs.* It will be the first year all three programs penalize physicians for reporting unsuccessfully, and penalties will continue to grow in future years. When added up, unsuccessful reporting in 2015 will subject physicians and other eligible providers to Medicare payment penalties as high as 11 percent, levied in future years.