By Ken Congdon
Follow Me On Twitter @KenOnHIT
I recently referenced several challenges facing physicians practices (e.g. reimbursement cuts, rising IT demands, regulatory requirements, etc.) in my recent feature story Practices Under Pressure: 6 Ways To Cope With Rising Health IT Demands. Well, the toll these challenges are taking on doctors’ offices was palpable at this year’s MGMA (Medical Group Management Association) conference. The event was held October 6-9 at the San Diego Convention Center, and key practice stakeholders (e.g. physicians, practice administrators, etc.) flocked to the location in search of guidance, answers, and hope for the future. Luckily, MGMA delivered with a solid slate of educational sessions and an exhibit hall filled with the latest technology solutions geared toward helping group practices weather the storm. The following are my top takeaways from MGMA 13.
Tales Of The Demise Of The Private Practice Are Exaggerated (Sort Of)
Many pundits (and doctors for that matter) feel that private practices will be soon become extinct as a result of the changing healthcare landscape. Indeed, many independent practices are opting to sell their practices to health systems or close their doors rather than struggle to adapt to new reimbursement and health IT demands. However, it’s clear there is a contingent of doctors that are passionate about remaining independent.
For instance, in an educational session exploring practice alignment and integration options, the following question was posed to the audience — “Why would a physicians practice want to remain independent in today’s changing healthcare landscape?” A female physician stepped forward and said (paraphrasing), “Because I care about my patients. I want to be the one that outlines the treatment options in their best interests. I don’t want this to be dictated or controlled by a health system that can let profit and loss dictate their actions.” Her response was rewarded with a standing ovation by session attendees.
While several doctors share a strong desire to remain independent, recent data shows that this group is becoming the minority. For example, according to research by MGMA and Accenture, the share of physician-owned medical practices dropped below 50% in 2009 and continued a steady decline in the four years since. Many industry vendors that cater to small independent practices seem to have conceded that this trend will continue (to a point).
“We believe the decline in independently-owned physician practices will level off at about 30%, and we remain focused on serving this community,” says Steven ZoBell, chief product and technology officer for AdvancedMD.
Even if 30% of medical practices remain independent, it remains to be seen if these practices will look the same as they do today. For example, one way independent practices are responding to Medicare reimbursement cuts is to drop Medicare (and all payer ties for that matter) in favor of concierge medicine. It will be interesting to see how this trend evolves and how it impacts the independent practice community.
Cloud Options Gain Favor In Year Of The Great EHR Switch
2013 was labeled by the Brown-Wilson group as “The Year of the Great EHR Vendor Switch” as many hospitals and medical practices seek to rip and replace their existing EHRs due to increasing dissatisfaction with underperforming technology. It seems as if many medical practices rushed into an EHR buying decision years ago without necessarily knowing what functionality the practice would require from the system or how the EHR would impact existing clinical workflows.
It was clear at MGMA 13 that today’s medical practice is a much more educated EHR buyer, and many are ready to apply this knowledge to selecting a new EHR solution that better meets their needs. Along with increased EHR acumen is a growing acceptance of cloud-based technologies among medical practices. Like outlined in my recent post Do Health Providers Finally Trust The Cloud?, doctors’ offices not only seem to trust cloud-based EHRs, but in many cases, are seeking it out as the platform of choice in their rip-and-replace initiatives. Many practices at MGMA referenced the following attributes as key advantages of a cloud-based EHR — 1) No equipment to install or maintain; 2) Anywhere, anytime access to patient data; 3) Pay-as-you-go (i.e. no contracts); 4) Easy setup/upgrades; and 5) Scalability.
Population Health Management For Practices
To me, one of the most surprising trends at MGMA 13 was the heavy focus on population health management, particularly from the vendors exhibiting at the event. I guess I thought of population health management as more of a focus area for health systems or ACOs, and not yet a primary concern for medical group practices. As it turns out, that was precisely the reason so many vendors were pushing population health management solutions and messaging at MGMA 13.
“Population health management doesn’t have to be a huge, expensive tool like IBM Watson,” says Todd Rothenhaus, CMO of athenahealth. “The technology can be affordable to physicians practices. Moreover, population health management will be an essential tool for practices to monitor and improve performance going forward, allowing them to not only survive — but thrive — during this period of unprecedented change in healthcare.”
Ultimately, population health management tools will help medical practices coordinate care and deliver targeted, patient centered care. However, most practices will initially get the largest return on population health management technology by leveraging it to ensure their financial health.
“By providing physicians with detailed data on their expenditures and claims activity, population health management solutions can empower medical groups to take control of their finances, and proactively take measures to cut costs or accelerate cash flow,” says Rothenhaus. “This insight will be increasingly important to the ultimate success or failure of medical practices, particularly in the short term.”