A medical practice leader’s guide to 2020

A new year is already underway, and MGMA subject-matter experts see three key topics on many patients’ minds, which medical practice leaders will need to monitor and manage in 2020:

1. Cost — Healthcare consumerism and pricing transparency will continue to garner attention. With high deductibles and coinsurances, adults in the United States are utilizing the Internet more than ever and searching for quick and easy access to high-quality healthcare. Patients are increasingly expecting pricing transparency — about 75% of patients look up procedure costs online, per a recent TransUnion Healthcare survey. Moreover, significant media attention has made patients more aware of surprise medical bills and legislative attempts to curtail the practice. MGMA Government Affairs will monitor this issue for developments throughout the year.
2. Quality — As patients become more informed and empowered consumers in 2020, they will seek better quality care. Quality extends outside the exam room as patients look for a positive experience from the time they check in until they walk out the door. With a recent study pointing to the patient experience and quality declining following hospital mergers and acquisitions, the imperative for medical group leaders to focus on quality improvement activities represents an opportunity to stand out in 2020.
3. Convenience — With more convenience-based medical clinics popping up, patients are expecting to have access to a provider any time of day between these clinics and telehealth options. This creates a greater challenge for traditional medical practices to improve access and see patients in a timely manner.

 
To best address these growing expectations from patients, providers and medical practices need to continue to innovate in 2020 in the following areas:
 

• Review your workplace culture and build a strategy for physician and employee retention. A shortage of nearly 122,000 physicians is projected by 2032 in the United States according to the Association of American Medical Colleges (AAMC). Additionally, the U.S. Bureau of Labor Statistics (BLS) reported in November 2019 that national unemployment stood at 3.5%. With such a low rate paired with the looming shortage, the competition for physicians and employees will remain very high. Employers will need to make sure they have a healthy culture that appeals to job seekers and competitive pay rates to attract and retain high-performing providers and employees. Healthcare is a demanding field, and methods to prevent and cope with burnout for providers, administrators and staff members should be taken into consideration as well.
• Focus on data and key performance indicators (KPIs). It’s crucial that practice administrators and providers focus on hitting their established KPIs and use data to benchmark against industry standards. This will help identify top performers or areas of focus to improve operations and thrive in your specialty and the industry.
• Increase focus on providing quality value-based care. With the continued push to shift away from a pure fee-for-service (FFS) model toward value-based care, it is increasingly important for practices to understand their quality metrics and patient outcomes, especially in terms of selecting metrics to incentivize in new value-based payment programs. Doing so helps shift a practice’s attention to providing better care and reducing the overall cost of the care, and it also sets the stage for earning revenue from shared savings arrangements and preparing for taking on risk in the coming years.
• Create or update strategic plans for short-term and long-term goals. Healthcare leaders need to ensure they have 90-day action plans and one- to three-year strategic plans outlining ways to grow their service lines. Review opportunities with new technologies, including automation, rural health/outreach, telehealth, imaging and new procedures to grow the patient base in line with those strategic plans. Practices should also make plans to invest in technology as it relates to streamlining patient check-in, paperwork and remote visits, as those needs will continue to grow in 2020. Chat bots and other A.I.-based technologies are being used more frequently by practices and call centers. Technological growth will also continue in the areas of advanced diagnostics, pharmaceutical and patient care.
• Explore new reimbursement opportunities. Medicare’s 2020 Physician Fee Schedule includes provisions that may allow physicians to be reimbursed for services they have previously done for free. For instance, group practices that bill for Chronic Care Management (CCM) services can now use an add-on code to account for additional time spent on non-complex CCM services. Medicare also expanded coverage of telehealth services and eased restrictions on the patient consent process. Practices should review these policies to keep up with competition and the evolving care delivery landscape.
• Don’t fall behind on MIPS reporting. Practices participating in the Merit-based Incentive Payment System (MIPS) should review changes for the 2020 performance year to ensure they report on the appropriate measures. It’s important that practices check with vendors to verify that the necessary measures are included in their EHRs. Meeting MIPS reporting requirements may not result in significant bonuses for your practice but will save you from steep financial penalties.
• Network with other leaders. Administrators should connect with experts and peers across the country in their field on what they are doing and how they are doing it to grow their practice. Healthcare leaders can obtain certification, such as ACMPE board certification, to demonstrate their expertise and to grow their value within their organization and the healthcare field.
• Stay up to date on changing rules and policies. With constantly evolving government requirements, it’s essential to keep a pulse on legislative and policy developments that could affect your practice, particularly if you serve a high Medicare population. While Medicare’s annual Physician Fee Schedule and quality reporting changes are arguably the most important, MGMA urges you to keep an eye on legislative efforts, such as those that address surprise billing and prior authorization. Subscribe to the weekly Washington Connection newsletter to stay informed.