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  • 19 Feb 2019 1:11 PM | Cathy Herring (Administrator)

    February 7, 2019 
    The Honorable Richard E. Neal
    Committee on Ways and Means
    1102 Longworth House Office Building
    Washington, DC  20515 

    The Honorable Kevin P. Brady
    Ranking Member
    Committee on Ways and Means
    1139E Longworth House Office Building
    Washington, DC  20515


    Dear Chairman Neal and Ranking Member Brady: 
    Patients, physicians, and policymakers are deeply concerned about the impact that unanticipated medical bills are having on patient out-of-pocket costs and the patient-physician relationship.  Health insurance plans are increasingly relying on narrow and often inadequate networks of contracted physicians, hospitals, pharmacies, and other providers as one mechanism for controlling costs.  As a result, even those patients who are diligent about seeking care from in-network physicians and hospitals may find themselves with unanticipated out-of-network bills from providers who are not in their insurance plan’s network, simply because they had no way of knowing and researching in advance all the individuals who are ultimately involved in their care.  Physicians and other providers are limited in their ability to help patients avoid these unanticipated costs because they, too, may not know in advance who will be involved in an episode of care, let alone other providers’ contract status with all the insurance plans in their communities. 
    As Congress develops potential legislation to provide relief to patients from health care costs that their insurance will not cover, we urge your consideration of the following policies. 

    Click here to read the full letter. 

  • 19 Feb 2019 9:05 AM | Cathy Herring (Administrator)

    Date: February 19, 2019

    The healthcare industry is constantly growing and introducing new ideas. MedCity News reported how “innovation in healthcare delivery, the use of data analytics to unlock new clinical insight, disruption of the existing pharma business model and the continued shift to value-based care” are the reasons why investors are putting more money in the healthcare industry than ever before.

    Healthcare has seen high investments across all sectors. Specifically, MedCity News stated that “one of the biggest magnets for investment in New York has been insuretech start up Oscar Health.” However, there wasn’t as much growth within digital startups. MedCity News blamed this on “volatility in the public markets.”

    MedCity News elaborated on a few more drivers contributing to the growth in investment. The direct-to-consumer health companies that provide “streamlined and personalized consumer experience” are large influencers. San Francisco-based One Medical is also furthering innovation by providing “telehealth to in-home visits to concierge medicine, and often all in one package.”

    MedCity News described these companies as creating a shift towards better patient engagement and care navigation, and for good reason, according to Cedar CEO Florian Otto. 

    “Health insurance is an area that can be much more patient friendly.” Otto was quoted in MedCity News. “Understanding patient benefits should be easier and insurers could be a more active partner in how patients consume healthcare.”

  • 13 Feb 2019 12:01 PM | Cathy Herring (Administrator)

    Date: February 8, 2019

    The healthcare industry is constantly on the lookout for new and exciting ideas. Caitlin Cronk, the associate director of digital planning and strategy at NYU Langone, is always driving towards the next technological innovation. MobiHealthNews reports how Cronk and her colleague, Nader Mherabi, find the next new thing.  

    The two started by gathering “a lot of different ideas from industries that are consumer and customer focused.” While researching, Cronk would learn from “what worked and what didn’t across an array of fields.” Some of the industries they investigated ranged from the travel industry to the consumer products industry.

    MobiHealthNews outlines how Cronk and Mherabi used a few different techniques when learning about patient engagement behavior. The two colleagues felt that “it’s always important to get the end user’s voice into the innovation process.” Cronk stated that “we have different forums that our patient experience team get us connected with” and they “have also done some market research and leveraged some market surveys.”

    MobiHealthNews reports that the focus of this system right now is “patient access and telemedicine, as well as experiences across radiology, obstetrics and the post-procedural space.”

  • 05 Feb 2019 10:02 AM | Cathy Herring (Administrator)

    Date: February 5, 2019

    Recent events at Chicago Mercy Hospital have brought attention to the threat of violence at the workplace, specifically healthcare. Medical Economics outlines this threat and how to combat this issue.

    Compared to other industries “U.S. healthcare workers are three to four times as likely to experience workplace violence,” according to the article. However, after the Emergency Preparedness Final Rule in 2016 was passed “it dramatically upped the regulatory ante and spurred additional progress in medical facilities.”

    Medical Economics describes the five elements that OSHA guidelines states are necessary for a violence prevention program and then outlines the steps for implementing this program. The first step is to define and assess risks and how these risks may be different for facilities of different sizes, locations, etc. It’s also important that all interested parties are involved in program design to ensure that “all needs are met.” Once the program is designed there needs to be a “strategic, thoughtful, connected, and comprehensive” process of implementation. Finally, “decision-makers should reassess and potentially update mitigation strategies on an ongoing basis.”

    Medical Economics states that if healthcare facilities continue to develop these programs they will “deliver on this promise of providing high-quality care in a comfortable, safe, and secure environment.”

    What to learn more about risk management? Click on this MGMA Insight Article.

  • 29 Jan 2019 8:11 AM | Cathy Herring (Administrator)

    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 8:14 AM | Cathy Herring (Administrator)

    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 9:51 AM | Cathy Herring (Administrator)

    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 | Cathy Herring (Administrator)

    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 | Cathy Herring (Administrator)

    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 7:16 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

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