Across specialties, ownership types and size, the healthcare organizations represented by the thousands of attendees at MGMA19 | The Annual Conference were united not just by proximity and a desire to improve their businesses — their concerns and challenges sounded familiar, as well.

Across four days in New Orleans, a consensus developed around where medical practice management is today and where its practitioners are looking to transform the healthcare industry to improve it.

Regulatory burdens

More than three in four attendees (76%) responding to an Oct. 14 MGMA Stat poll said they believe regulatory burden has increased in their practice in the past year, compared to 22% who said it stayed the same and 2% who responded that it decreased.

Major areas of concern cited by those respondents and MGMA members who responded to the Annual Regulatory Burden Survey included administrative requirements connected to prior authorization, the Quality Payment Program, audits, appeals, lack of EHR interoperability and Medicare Advantage chart audits.

As one participant in the regulatory burden survey noted, “we used to devote 80% of time to patient care and 20% to regulatory, compliance, insurance and credentialing issues. Now we spend more time on issues not related to patient care.”

Burnout

While physician burnout was a major topic of discussion across multiple sessions, it’s a concern for practice leaders on the administrative side, too. An attendee MGMA Stat poll on Oct. 15 found that 38% of healthcare leaders reported high levels of burnout in the past year, with 43% reporting moderate levels and 19% noting low levels.

Joseph DeVeau, MD, MHL, First Georgia Physician Group, noted in his Oct. 14 session that he was confused as to why more physicians did not address the issues they have with burnout, but that he invested time to pursue a healthcare leadership program to spur conversation.

His recommendations to mitigate burnout? Ditch the “lone ranger” mentality that physicians have to do everything, and work to standardize the patient encounter to get to what matters most rather than being barraged with a range of issues that may not be vital to the care plan. DeVeau also said team documentation can be a major help to build a culture in which work is fun and physicians can feel as though they can say, “no,” when a task would be better handled by another team member.

Telehealth

Employing telehealth and remote patient monitoring strategies to increase patient engagement and find a return on investment (ROI) was another big topic in education sessions and in the Exhibit Hall.

In addition to 30-minute, peer-led conversations in the Spark Session space, the ability to improve patient access via telehealth and modify provider scheduling to be more flexible was on many attendees’ minds.

Recent regulatory changes have made it possible for more practices to offer virtual medical, health and education services, particularly as asynchronous telehealth has become reimbursable in many states, according to Keith Dressler, DDS, MSD, chairman and chief executive officer, Rhinogram.

Dressler shared three case studies that illustrated the value of telehealth programs in improving patient engagement and outcomes, as well as practice ROI. As Dressler emphasized, “with value-based care, there’s motivation to keep patients healthier and happier and engaged … and there’s proof that telehealth can make a difference.”

Staying independent in an evolving industry

In an independent medical practice, the physicians aren’t just the ownership — they’re also the product, so to speak, according to Cameron Cox III, MHA, FACMPE, chief executive officer, MSOC Health. The business ownership aspect of healthcare can fuel emotional exhaustion that’s sometimes a key contributor to burnout. That’s why it’s time to take a different approach to disruptive elements of healthcare in the United States, he says. “Our mistake in healthcare is that we think technology is causing this movement,” Cox says. “But it’s not. It’s the person” — the average patient consumer — who is looking for healthcare to deliver with the same business savvy that other industries do.

Farzad Mostashari, MD, chief executive officer and founder, Aledade, echoed that sentiment, noting that it’s best for independent practice leaders to position themselves as high-value options who care strongly and personally for patients amid a wave of consolidation and competitive erosion. For venture capital investors, healthcare is seen almost entirely as a business; but for independent practice leaders, “it’s a calling,” he says.

In a lively roundtable discussion moderated by Charles Porth, FACHE, administrator, Florida Heart Associates, and Kerri Gantt, MHA, LHRM, FACMPE, administrative director, Gastroenterology Associates of SW Florida, PA, attendees shared their experiences with recruiting physicians and best practices for making independent groups alluring to residents and finding cost-effective means of screening applicants.

Social determinants of health

Healthcare leaders also showed interest in taking a team-based approach to identifying and addressing social determinants of health (SDoH), according to Shaheed Koury, MD, MBA, FACEP, chief medical officer and president, clinical operations, Quorum Health, and Stephen Stewart, partner and chief growth officer, CareHarmony.

“We need the community, we need the family involved, we need friends, we need the chamber of commerce, we need the politicians, and we need the churches … now you’re tackling all the social determinants of care,” Koury said.

In their session, “Leveraging Social Determinants of Health Data for Value-based Care Success,” attendees learned how collecting and examining social data through assessment and patient interaction can help keep people out of hospitals and help them live longer. This can be accomplished through the three “A’s” of SDoH data: Aggregate, analyze, act. “The data can be the greatest you ever had, but if you don’t have a human intervention in which you can affect a person’s life with that data … you are going to fail,” Koury asserted.

Digital engagement and consumerism

Chrissy Daniels, MS, partner, Press Ganey Associates Inc., knows a lot about how consumers do research, because she’s focused on researching consumers.

“We know how to ask questions,” Daniels said in her session on building patient consumer loyalty. Daniels noted that most consumers rely on their own online research rather than asking for word-of-mouth recommendations from friends and family. In a consumer trust survey, Daniels noted that 95% of consumers think patient reviews are somewhat to very reliable — but that may be more of an issue of consumers trusting their own ability to research than the reviews themselves.

“It’s a trust-but-verify world,” Daniels said. Patients look for negative reviews, and there is increasing skepticism of what consumers view as advertising. They know healthcare is not perfect, she said, and if they only see positive reviews, they may suspect the reviews were scrubbed or that some of them are fake.

For medical practices, the patient review search should focus on functionality, she said. Being able to search for a doctor online should yield a single link that can lead the searcher to a scheduling portal. “It’s not just social presence — it’s giving people what they want,” Daniels said. 

Hambsh welcomed as new MGMA-ACMPE Board Chair

On Oct. 16, outgoing MGMA-ACMPE Board Chair Todd Grages, MSBA, FACMPE, FACHE, passed the gavel to incoming Board Chair William Hambsh, CPA, FACMPE, chief executive officer, North Florida Women’s Care.

In closing out his year as Board Chair, Grages urged attendees to conclude the conference with three initiatives in mind: Getting involved with MGMA and its many volunteer opportunities, taking what they learned back home with them and focusing on leading the industry into the future.

Hambsh, who has been on the board since 2014, recounted his “passion for accounting” that sparked his journey into healthcare and guided him to lead the largest OB/GYN practice in Tallahassee, Florida. He said his father’s death at an early age helped sharpen his focus on exercise, meditation and eating well — just a few of the ways he attempts to ignite excellence in his personal life.

The Board of Directors also welcomed three new members:

• Jennifer “Nifty” Gosney, CPA, FACMPE, regional director, Finance Surgical Services, Scott & White Health System, Temple, Texas
• Michael O’Connell, MHA, FACMPE, FACHE, senior vice president, Operations, Stanford Healthcare, Newark, Calif.
• Lola Osawe, MSHA, FACMPE, FACHE, chief executive officer, Chesapeake Eye Center & Surgical Services, Maryland/Military Assignment: Lt. Col., USAF, MSC (IMA Officer), Branch Chief, Process Improvement, Office of the Command Surgeon, Air Education and Training Command, JBSA, Texas