Las Vegas: 2017 MGMA Financial Management & Payer Contracting Conference
This year’s MGMA Financial Management and Payor Contracting conference, held recently in Las Vegas, brought together CFOs, CEOs, Finance Directors and other stakeholders focused on improving financial performance within their organizations amid uncertainty of our current healthcare environment. Republican Healthcare Reform was on everyone’s mind.
The agenda consisted of a comprehensive curriculum designed to address various financial management strategies for medical practices to navigate the transition into value based healthcare from fee-for-service medicine. Topics included revenue cycle management, contract negotiation, value-based payment methodologies, provider compensation strategies and harnessing business intelligence.
Over three days of lectures, breakout sessions and round table discussions, attendees were exposed to a broad range of ideas, best practices and tools to assist medical practices in achieving financial success. The resounding theme was that financial analysis, incentive-based compensation structures and advanced analytics are required to improve quality and deliver value-based care.
Perspectives on Current Trends
Speakers discussed the role of financial analysis in everything from the payor contract to the patient choice, and there was significant emphasis on the need for transparency. Some of the most salient points introduced by perspective are displayed in the table below.
Role of Financial Analysis and Transparency by Perspective
|Payor||Provider||Patients & Employers|
|Payers face pressure to share regular & complete cost data to engage providers in value based contracts.||Groups that become responsible for the total cost of care need to understand and manage the cost of network and downstream services (labs, imaging, urgent care).||Patients with high-deductible plans have become acutely aware of their increased responsibility for the total cost of care and demand information that many providers lack the system to accurately estimate.|
|Payers face pressure from sponsors, including public and private sources, to deliver cost reduction and to do so must identify most cost effective providers in their markets.||Groups need to review provider compensation models to distribute impacts of changing revenue models. RVUs may no longer be the measure of productivity.||Employers, the chief buyers of health insurance, are becoming aware of opportunities to contract directly with providers to circumvent plan costs.|
The conference was also replete with forward-looking sessions, despite the landscape uncertainty, and each was accompanied by experienced guidance. The common theme was change is coming, and now is the time to prepare.
One speaker, Denny Flint of Peak MSO in Colorado Springs, emphatically stated that “physician groups have NO CHOICE but to transform their practices into value-based care models.”
“Fee-for-Service is going away!” Fint added, highlighting that continued federal budget pressures and the passage of MACRA are the clearest heralds. As a call to action, he reminded us to remember Charles Darwin’s thesis: that the most adaptable survive – not the most intelligent or strong.
Change, for its own sake, can be destructive. Instead, the call for change was to reach a common goal. The American Healthcare System must deliver increased quality of care and better patient outcomes at a decreased cost. This message is a clear take-away, and it echoes in many forums.