MGMA In Practice blog

By David N. Gans, MSHA, FACMPE
MGMA vice president of Innovation and Research

We've all been watching as Congress considers legislation that will "reform" the nation's health insurance and healthcare delivery systems. The debate will probably continue long after Congress acts, but here's what you can do now to prepare your medical practice for a health system transformed by massive demographic and regulatory changes.

In a recent MGMA Webinar (free for members) I explored 15 strategies that practices should consider during these changing times:

1. Separate your personal political views from the assessment of how a practice can prepare for health reform legislation. Whether you agree with the rationale for the proposed legislation or not, the practice's response will likely be the same.
2. Recognize that health reform may or may not be passed into law. This is an opportunity for the practice to select a leader who can:
   • Monitor the public discussion
     Educate staff and physicians on the potential impact of legislation
   • Observe the perspective of payers, government, and providers
   • Describe the potential bias displayed in the "push polls" and commercials
3. Know that reform will come not instantly, but with a timetable that will range from 2010 to 2015 and beyond. The practice's preparations need to be on the same timetable as the legislation.
4. Review and improve internal data collecting, tracking and reporting procedures.
5. Evaluate the practice's investment in and use of health technologies, such as electronic health records, electronic prescribing systems and patient chronic disease registries.
6. Assess the practice's current ability to report quality metrics.
7. Identify best practices to reduce costs and improve quality.
8. Evaluate strategies to increase provider productivity.
9. Review administrative and billing procedures so insurance claims are paid correctly and promptly.
10. Evaluate the administrative performance of Medicare and commercial insurers who have the largest market share.
11. Develop a strategy for how to address increased patient demand.
12. Assess whether the current number of physicians and the mix of services are what the practice should have under a transformed healthcare system.
13. Assess how nonphysician providers are used in the practice and whether the practice should recruit additional nonphysician providers.
14. Determine how the practice could recruit new or replacement physicians.
15. Evaluate possible partnerships with hospitals and other medical groups to access capital, increase organizational clout, and perhaps qualify as an Accountable Care Organization.

Interested in hearing more? You can order the 90-minute Webinar on-demand that contains these tips and more.