Latest News in Healthcare

  • 29 Jan 2019 7:11 AM | Anonymous

    Date: January 29, 2019

    This installment of the article series runs counter to popular trends when it comes to setting physician compensation for physicians in health system practices. Many health systems pay their physicians solely based on data from physician compensation survey data or on valuations prepared using such data. Sole use of survey data in setting physician compensation levels, however, can lead to practice losses. Health systems that fail to consider the full range of physician practice economic factors are at-risk for never-ending red ink from their physician enterprise.

    We should first note that practice losses resulting from survey usage is not the fault of the survey data. It’s a user problem! Survey data are designed to provide information in statistical format (also known as descriptive statistics) about respondents to the survey. As such, surveys are highly useful for general benchmarking, providing a range of data for comparison purposes relative to the survey cohort.

    The problem arises, however, in the ways survey data are used in physician compensation-setting for health system practices. Two broad approaches for using survey data are observed in today’s marketplace.

    In the simplest approach, a specific percentile for compensation is selected as the appropriate level to pay a physician. Typically, the median or 75th percentile is selected for total compensation or the compensation per wRVU ratio. In practice, these rates may be blanketly used for all physicians with no consideration of the facts and circumstances for the physician’s practice. Such blanket use of this or that percentile is usually supported by claims about market conditions, regulatory guidance, or appeals to common practice (e.g., “this is how everybody does it”).

    The second approach attempts to match compensation with a physician’s production, typically based on wRVUs. A highly common form of matching involves paying a physician at the total compensation percentile that corresponds with the physician’s benchmark level of wRVU production. For example, a physician whose wRVUs benchmark at the 65th percentile for wRVUs is paid at the 65th percentile for total compensation.

    Another form matches the compensation per wRVU ratio to the benchmark level of wRVUs. Under this variation, the physician’s whose wRVUs benchmark at the 75th percentile is paid at the 75th percentile compensation per wRVU ratio. Yet another form uses the median compensation ratio for the quartile of production level for the physician as the blanket rate for paying a physician.

    This second approach is based on the belief that production is the only critical driver of compensation levels in the marketplace. No other economic factors impact market compensation for physicians. So, if you can track or benchmark a physician’s wRVU production, you can predict the market compensation for that physician.

    This view, however, doesn’t square with the reality of the data. Below is a scatter-plot diagram taken from MGMA’s pay-to-production plotter report from the 2016 Provider Compensation report for non-invasive cardiology.

  • 23 Jan 2019 7:14 AM | Anonymous

    Date: January 23, 2019 

    For more than a decade, MGMA has hosted the Financial Conference. It’s a chance for practice leaders to get together to solve the financial issues their practices are facing.

    In this episode of the Industry Insights podcast, we focus on those most pressing financial issues and learn strategies on how to address and solve those problems. As part of the lineup, MGMA Sr. Editor Craig Wiberg discusses The Financial Conference. Also, we hear from industry experts including Steve Dickens, Sanjay Seth, and Jim Malloy.

    Additionally, Erica Betz, project analyst for MGMA stat discusses how good data can improve a medical practice and Jaci Johnson gives the 411 on CPT coding changes for 2019.

    To listen to the podcast, click here

  • 15 Jan 2019 8:51 AM | Anonymous

    Date: January 15, 2019 

    Succession planning is a critical aspect of healthcare management. For long-term practice success, there needs to be a good plan for senior leaders, both clinical and non-clinical, who will someday leave the practice.

    Succession planning takes time and effort from the administrator and the practice shareholders. Being proactive with succession planning will help ease the burden on the practice when leaders depart.

    At times, administrators may feel as though they are reactive to problems, but when looking at the strategic plan of the organization, they must be proactive in succession planning. There is a significant cost associated with hiring and training new staff members. The cost of recruiting and training a new employee is double the salary of the person being replaced.1 As the baby boomers near retirement, it is crucial for healthcare leaders to determine the next leaders within their respective organizations. Succession planning allows the administrator to have a plan when a key member leaves or retires.

    For more material access, click here

  • 16 Jul 2018 8:43 AM | Anonymous

    Date: July 16, 2018

    MGMA Connection Magazine will be undergoing a transformation beginning January 2019 aimed at better serving all audiences that comprise MGMA's membership. 

    To read more and submit an article, visit MGMA's Website.

  • 11 Jul 2018 8:35 AM | Anonymous

    Date: July 11, 2018

    Currently, physician practices participating in value-based arrangements with Medicare Advantage (MA) plans may be required to simultaneously comply with MIPS in order to avoid a penalty on their Medicare Part B reimbursement. In response to MGMA advocacy urging reduced provider burden and recognition of practice participation in innovative MA alternative payment models (APMs), CMS is developing a demonstration to exempt qualifying practices from MIPS. CMS is also considering counting participation in risk-bearing MA APMs toward the Advanced APM pathway under MACRA beginning in 2018. MGMA will submit feedback in response to CMS’ planned demonstration. 

  • 07 Mar 2018 6:16 AM | Deleted user

    Subject: New Medicare Cards.

    Date: March 6, 2018

    Dear NV MGMA members and associates, this is a reminder that The Centers for Medicare and Medicaid Services (CMS) will be issuing new Medicare cards later this year. CLICK HERE for a PDF from CMS with very useful background information, as well as the following link:

    The new cards will have unique beneficiary ID numbers. Cards for beneficiaries in Nevada and Arizona will be issued sometime after June 2018, and those in California between April and June 2018.

    This may be confusing for some patients and families, so we recommend that you work with your staff to ensure that the information in your practice management systems are updated accordingly.

    NVMGMA Board

  • 12 Oct 2017 3:07 PM | Deleted user

    First Annual Women’s Leadership Breakfast A Big Success!

    On Friday, September 29, 2017, the Nevada Chapters of MGMA, ACHE and HFMA sponsored a dynamic panel of women leaders who shared their stories and advice with a packed house of over 100 attendees at Renown Regional Medical Center in Reno. The program theme was: “Leading Change by Changing the Way You Lead.” The panel members included representatives from healthcare, business and politics. The program, with panelists, is HERE.

    After a wonderful hot breakfast served by Renown, the keynote address focused on the need for courage in today’s work place. Panel members responded to questions from the moderator and audience members about how they advanced in their careers, what advice they would give women to be successful in the workplace, and how to communicate effectively and better relate to, and help mentor, employees and colleagues.

    Special thanks from all of us to Marena Works, who chaired the planning committee, representing NV MGMA. After reviewing evaluations from attendees, the committee has agreed to start planning in January for next year’s event, to be held in Reno next September. Planning has already started for the 2nd Annual Women’s Leadership Breakfast in Southern Nevada, will be held in March of 2018. NV MGMA will be keeping members in both the North and South updated on both events. Evaluations scored a weighted average of 4.87 out of 5 points for all 10 areas rated. All suggestions will be considered for planning next year’s event.

    Other members of the multi-association committee for Northern Nevada are: Jackie Shoupe and Leonard Hamer, also with NV MGMA, Debra May of Renown--HFMA, Michelle Joy of Carson Tahoe Health--ACHE, Dave Schweer of Dignity Health—HFMA and ACHE and Dana Lopez of Anthem Blue Cross, Las Vegas--HFMA. All were active members of the committee and contributed heavily to the success of the program. The paymaster for expenses was Larry Preston, representing HFMA.

    In addition to the venue and breakfast that was provided by Renown, major financial sponsors were Clark and Associates and The Nevada Insurance Agency. Affiliated professional associations were the Nevada Chapters of: HIMSS, AHIMA, NNA, NPHA and NPHF.

    For a picture gallery of the event, please click HERE.

  • 17 Aug 2017 7:09 AM | Deleted user

    No monthly meeting in September for Northern Nevada MGMA Members due to other conferences.

    Northern Nevada MGMA Members: There will be no monthly meeting in September due to other conferences taking place in September. Please consider attending one or both of the following events in September:

    September 21-22, HFMA Northern California/Nevada Fall Conference being held at the Resort at Squaw Creek and on September 29, Leading Change….By Changing the Way You Lead seminar being held at Mack Auditorium. Please visit these events by clicking the link above for full details. Join us!

  • 14 Jul 2017 7:49 AM | Deleted user
    July 13, 2017

    Regulatory Alert: CMS releases proposed 2018 Medicare physician fee schedule

    The Centers for Medicare & Medicaid Services (CMS) released the proposed Medicare physician fee schedule (PFS) rule for 2018. CMS will accept public comments on the rule until Sept. 11, 2017 and intends to issue the final 2018 PFS by Nov. 1, 2017. Visit our updated Medicare Physician Reimbursement webpage to view the full proposed 2018 Medicare PFS and read the CMS fact sheet under the "Other Resources" section.

    Among other changes, the proposed rule would:
    • Set 2018 Medicare payment rates for physician services, including a modest payment increase as a result of SGR repeal under the Medicare Access and CHIP Reauthorization Act;
    • Outline proposed RVU and payment changes for services CMS considers misvalued; 
    • Delay the start of the Appropriate Use Criteria (AUC) program until Jan. 1, 2019 and posts the list of newly approved Provider-Led Entitles and Clinical Decision Support Mechanisms, which will develop and document AUC for advanced diagnostic imaging services;
    • Retroactively lower PQRS reporting requirements to six measures;
    • Reduce Value-Based Payment Modifier penalties and hold groups harmless if they meet minimum quality reporting requirements; and
    • Seek input through a Request for Information about opportunities to reduce burdens on physician practices and make the delivery system less bureaucratic and complex.
    In a separate rule, CMS proposed changes to policies and payments regarding hospital outpatient departments and ambulatory surgical centers.

    MGMA will prepare an in-depth analysis of the proposed 2018 Medicare PFS for members and submit comprehensive comments to the agency. Stay tuned to the MGMA Washington Connection for updates and contact MGMA government affairs with questions by emailing or calling 202.293.3450877.275.6462 toll-free.

  • 21 Jun 2017 6:26 AM | Deleted user
    June 20, 2017

    Regulatory Alert: Medicare proposes 2018 MIPS and APM changes

    Today, the Centers for Medicare & Medicaid Services (CMS) released the proposed rule changing the Merit-Based Incentive Payment System (MIPS) and alternative payment models (APMs) participation options and requirements for 2018. Key provisions of the proposed rule would:
    • Establish MIPS reporting requirements for 2018;
    • Delay the previously-finalized 2018 requirement to upgrade 2014 Certified EHR Technology to the 2015 edition;
    • Increase the low-volume threshold;
    • Delay implementation of the cost component of MIPS;
    • Incorporate the option to use facility-based scoring for facility-based clinicians;
    • Offer the virtual group option for solo and small practices to aggregate their data for a shared MIPS evaluation; and
    • Outline criteria for qualification as a participant in an all-payer APM, beginning in 2019.
    MGMA Government Affairs staff are closely reviewing the proposed rule and will provide additional information to members in the coming weeks. The Association will submit detailed comments in response to these proposals to CMS. The agency will be accepting public comments on the proposed rule until Aug. 21, 2017. A link to the proposed rule and additional information is posted on MGMA's MACRA Resource Center.  

Managing chronic care populations: Improve health & contain costs

April 29, 2019

Healthcare in the U.S. continues to move from volume-based care to value-based care. In the process, managing chronic disease has become both a universal imperative and a foundational element of a patient-focused population health program.

Leaders of many physician groups—including those partnered with multi-hospital systems—look for a solid, practical approach to chronic care management. Though difficult, practices are changing up their organizational structure to support alternative payment models that reward maintaining a healthy population.

This paper, a joint effort between Virence Health and Physicians Medical Center, PC, used a real-world example of how PMC introduced a successful population health program into its culture and, by doing so, made the shift to proactive, team-based care, allowing them to leverage their data and improve the lives of their patients.

Click Here to Read More

Three Environmental Factors Impacting the PPM Industry and Getting Deals Done

April 23, 2019

The PPM industry is by no means immune to the ebbs and flows of a traditional marketplace. Since the consolidation bubble burst in the 1990s, PPMs have gone from practically extinct to a once-again substantial component of the health care delivery system. But with greater influence comes more pressure to respond, and adapting to today’s complex operating environment requires those in the PPM industry to ensure they are building the foundational structure needed to help practices adapt to external factors and achieve long-term success.and achieve long-term success.

Click Here to Read More

Social determinants of health in an ACO for better population health

April 16, 2019

Valerie was a 31-year-old woman with uncontrolled diabetes, asthma, hypertension and was morbidly obese; she also had a history of trauma and depression. She increasingly was a no-show for appointments and would go to the emergency room instead of her primary care visits at Massachusetts General Hospital in Boston.

It wasn’t until Mass General implemented a social determinants of health (SDoH) survey that the providers learned that Valerie faced homelessness — until then, a P.O. box and a telephone number gave no indication of the larger issue in her life. They also learned that, despite being born and raised in Boston, Valerie could not read and write in English, her primary language.

Through SDoH work, Mass General staff were able to direct Valerie to emergency housing and ask what her goals were beyond health: Learning English, getting a job, securing an apartment and reuniting with her 3-year-old daughter, who was taken at birth due to Valerie being homeless.

As with most of us, social factors such as housing, education and a safe environment largely lead to better health outcomes.1 In Valerie’s case, her factors meant insufficient healthy food, lack of refrigeration for medication and issues with blood pressure heightened by living in a van and a lower sense of personal safety — all directly affecting the care providers working with Valerie.

Click Here to Read More

Nevada MGMA
PO Box 3403, Hamilton, NJ 08619