Frost & Sullivan was in attendance at the MGMA conference held in early November in San Francisco. The conference featured high anticipation among attendees who looked to MGMA for guidance on the final rules of MACRA, launched just two weeks prior. Additionally, they were keen to understand the potential implications of the US presidential election, and the general direction of healthcare reform, especially the move to value-based care and the growing role of information technology.
The key theme of the conference prioritized the importance of medical practice transformation amid regulatory disruption and changing patient preferences. Many sessions identified essential value-levers of comprehensive medical practice overhaul and examined ‘next-steps’ for medical practices.
Key Areas of Concern for Medical Practices
Conversations with MGMA constituents including medical practice owners, health IT vendors, practice line managers, clinicians, and others revealed that most practices are far behind the ideal value-based healthcare curve. Practices are struggling to demonstrate the basics of IT-enabled care, such as:
- Digitizing quality reporting and benchmarking at an enterprise and patient level
- Optimizing EHR usage for rendering personalized care at point of service
- Using a robust RCM platform that streamlines financial performance
- Devising population health management (PHM) initiatives that stratify patient risk and support proactive reach out
- Embracing patient engagement programs that improve patient loyalty and advance patient satisfaction
- Convincing workforce to embrace automated care management, wearable-integrated patient monitoring and telehealth
- Leveraging IT-partnerships with payers, parent-enterprises or other third-party organizations to implement value-based care programs
To meet these challenges, MGMA emphasized strategies for both volume and value-based medical practices.
- Fundamental transformation aided by healthcare IT and team-based care - Top-down transition is feasible with payer support, physician leadership, and the right vendor partnerships. Payer support should validate the trade-off between cost optimization and care quality improvement, physician leadership should pioneer team-based care, and vendor partnership is imperative to drive all techniques necessary to coordinate clinical, financial and operational departments.
- Optimization of RCM for better financial performance - RCM will remain a key business priority for the next 2 years. Medical practices will strive to optimize their revenue cycles by deploying agile analytics solutions that analyse and visualize financial performance at enterprise, service and patient levels.
- Design & deployment of PHM initiatives that emphasis on coordinated care and data driven decision making -
PHM remains a progressive concept for many medical practices. Those that are ready to embrace PHM not only look to prevent readmissions but also strive to identify patients who are at risk of gaining chronic conditions based on various behavioural factors, thus seeking vendors who enable early identification of comorbidities and initiate personalized community reach out through both digital and manual mediums
Value differentiation of independent and hospital-acquired medical practices
MGMA realizes that value-based care requirements of independent and integrated medical practices are not likely to remain uniform; a variety of approaches are at play. The conference featured multiple sessions for integrated medical practices and provided crucial insight and evidence on possible ACO partnerships or managed care contracts.
About the Author: Koustav has several years of experience working with global CXOs on forming growth strategies, product strategies and competitive assessment. In his current role as Senior Analyst for Frost & Sullivan’s Connected Health practice, Koustav advises healthcare ecosystem players including healthcare IT providers, hospitals, and ACOs on value based care and population health management strategies.