The Medical Group Management Association (MGMA) has submitted a letter to the Medicare Payment Advisory Commission (MedPAC), an agency that advises Congress on issues affecting Medicare, opposing its draft recommendations that would repeal the SGR by applying a ten year freeze to payments for a narrowly-defined set of primary care services. These services are estimated to account for approximately eight percent of Medicare spending.

The remaining 92 percent of Medicare expenditures would be affected by 17 percent over the first three years of the proposal and would then be frozen for the remaining seven years. Specifically, MGMA challenged MedPAC on its departure from earlier proposals that recommend a one percent increase in physician payments for 2012. MGMA’s historical cost data analysis predicts increases in multispecialty group practices’ operating costs over the next ten years.  (MGMA Washington Connection)

MGMA expressed its support for H.R. 674 in a letter dated October 7, 2011, which would repeal the 3 percent withholding requirements that are scheduled to take effect on January 1, 2013. The new law mandates that federal, state and local government entities must withhold 3 percent of all payments made for services or property, including payments made including payments under the Medicare program. MGMA is deeply concerned that if the 3 percent withholding requirement is imposed on providers it would cause serious cash problems for group practices as well as operational disruptions and administrative burdens when verifying amounts withheld by Centers for Medicare and Medicaid Services (CMS). The bill will first be considered by a vote on the U.S. House of Representatives floor the week of October 24.  (MGMA Washington Connection)

With compliance just 80 days away, MGMA remains concerned that practice management system vendors and health plans will not meet the January 1, 2012, deadline to transition to HIPAA Version 5010. This could impact the ability of physician practices to send and receive compliant electronic transactions. MGMA is working with members to gauge the readiness level of practices and their trading partners. These electronic transaction standards include the claim, remittance advice, patient insurance eligibility verification, claim status and others. If practices cannot transmit claims and other electronic transactions using the new format by the first of the year, they run the risk of experiencing significant disruption. Should that result, MGMA and its members will use this information to request that CMS develop an appropriate contingency plan. 

The MGMA will convene its 2011 National Conference beginning Oct. 23rd through Oct 26th.  This conference will be one of the most important in MGMA’s history with the introduction of the new MGMA CEO, Susan Turney, MD, who will replace William Jesse, MD, who retired this past year.  Jesse has continued as temporary CEO, while a national search went on for the new CEO of MGMA.

In addition, the MGMA and the ACMPE Boards have been engaged in a joint visioning process for almost two years to determine how we can meet members’ needs in a transforming healthcare environment. We have a unique history, a unique and historic opportunity to lead our members into the future of managing physician-led care and helping members navigate a variety of complex delivery system models. The joint boards have concluded that we can achieve that goal more effectively as one cohesive entity.  After careful evaluation and input from volunteer leaders, the MGMA and ACMPE Boards are unanimous in proposing to the members that MGMA and ACMPE unite to form a new association. While every member of our Boards supports this initiative, all MGMA members and ACMPE Fellows will be asked to approve the strategy to integrate MGMA and AMCPE into a new, unified organization with a vote on October 25^th.

Since both of their inceptions, MGMA and ACMPE have legally been two separate organizations with two separate staffs.  In reality, MGMA and AMCPE share much of the same association staff and operate in the same headquarters building. Although both organizations are financially sound, becoming one organization will make the new association more efficient. Efficiencies will be realized by having:

• Staff time saved from supporting two organizations and their respective Boards,
• One financial audit,
• One unified strategic plan,
• One Board of Directors.

We are also developing some additional innovative membership options to reflect our new stakeholders, such as those working in large hospital systems or integrated delivery systems. Under this new structure members would see:

• One professional membership with one single dues payment;
• Increased member value, by eliminating duplicate costs of two organizations;
• Stronger membership growth  allowing us a greater voice in advocacy efforts;
• Greater membership engagement to provide more opportunities for leadership roles;
• Increased awareness , value participation in the certification program;
• Expanded recognition, prestige and desirability of the credentials, leveraging brand recognition, thereby increasing the visibility of our credentials throughout the healthcare industry.

Having been a part of the two year process of learning and re-inventing ourselves, I will have to say these last two years on the board have been some of the most challenging I have ever been involved with belonging to an organization. I am looking forward to my third year on the combined Board if the members approve the recommendation to form this new association. Organizations and leaders who are forward-thinking and embrace change will be the most successful in this evolving environment. 

Bill Appling, MBA, FACMPE, is president of Watkins Uiberall Health Care Consulting. He has faculty appointments at the University of Memphis in the Fogelman College of Economics and Business, where he teaches in the Masters of Health Care Administration program.

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