Medicare Compliance & Reimbursement

MGMA gets real about PQRS, value-based modifier.

Many medical professionals feel like they’re drowning in a sea of administrative requirements as quality initiatives grow, and one organization is not afraid to voice these sentiments on practitioners’ behalf.

The Medical Group Management Association (MGMA) dubbed Medicare physician quality reporting programs as “needlessly complex” and “not improving patient quality.” These conclusions were based on an October 2014 survey of MGMA members that represented more than 1,000 medical groups and 48,000 physicians nationwide.

The irony: “A significant majority of respondents indicated these programs negatively affected practice efficiency, support staff time, and clinician morale,” MGMA reported. Furthermore, 82 percent of respondents said they already engage in their own internal processes to improve clinical quality.

“Medicare has lost focus with its physician quality reporting programs,” said Anders Gilberg, MGMA senior VP of government affairs in a press release. “Instead of providing timely, meaningful, and actionable information to help physicians treat patients, this has become a massive bureaucratic reporting exercise. Each program (Value-Based Performance Modifier, Physician Quality Reporting Initiative, and EHR meaningful use) has its own set of arcane and duplicative rules which force physician practices to divert resources away from patient care.”

“We have repeatedly urged CMS to support, not punish, physician group practices engaging in quality initiatives and immediately take action to truly harmonize quality reporting in Medicare,” Allison Brennan, senior advocacy advisor MGMA tells Eli. “The complexity of these programs, including the VBPM, and resulting physician frustration, has reached an all-time high.”

Other organizations have been less vocal, if not supportive, of Medicare’s quality initiatives. “ACP supports transitioning our health care system to a value-based payment approach, rather than a volume-based payment system,” says Shari Erickson, VP of governmental affairs and public policy for the American College of Physicians. “The College believes that a new value-based system should facilitate coordinated, comprehensive, longitudinal care provided by physicians working in collaboration with other health care professionals.”