MGMA 2008: MGMA CEO shows sense of frustration

Hello to all of you from San Diego, the lovely California city playing host this year to the Medical Group Management Association's annual conference. As usual, the show has drawn a healthy crowd, with 2,800 paid attendees and more than 5,300 people on site for the event. That includes, of course, a double handful of vendors--363 to be exact--all of whom stand ready to explain why their gadget or software can manage your patient data, resolve your rejected claims and make your morning coffee, too--decaf or caffeinated feature optional.

One of the highlights of yesterday's show was a press-only lunch featuring a presentation by Dr. William Jessee, president and CEO of MGMA. I say "highlights" not because anything terribly newsworthy came out of it, but because it offered an interesting insight into the MGMA--and by extension, some of the major players in the medical group sector. (By the way, I want to offer my kudos to Dr. Jessee for offering a clear, detailed presentation of MGMA's agenda with little if no smoke and mirrors--an admirable example of transparency.)

While far from offering a grim picture of the future of medical practices, the news wasn't too encouraging either--and the initiatives Jessee outlined were aimed at working within the system rather than making any major changes. This may be a sensible course of action, particularly at this pivotal point in time between presidents, but taking the middle road is a bit unusual for an advocacy organization. Maybe I'm projecting here, but I sensed an undertone of frustration in his otherwise upbeat talk.

If Jessee and his colleagues are discouraged, it's not too surprising. After all, financial conditions aren't good for practices. As the new MGMA survey notes (see a separate report on the study here) physician practices are bracing for a 20 percent cut in Medicare payments in 2010, their costs are rising faster than revenues, and specialty physicians' compensation isn't keeping up with their productivity. Meanwhile, given the calamitous state of the financial markets, practices have much less access to capital than unusual. That's tough for any business, but particularly for ones being pressured to make costly IT investments to support quality and clinical data initiatives.

So, what's a beleaguered professional organization to do? Focus on fixing what it can, I suppose. The group is working on a broad  initiative focused on reducing administrative complexity in the system, including a study looking at what savings might be accomplished if all health plans used a single, standardized type of patient insurance ID card. While this sounds like quite a promising idea to me, it doesn't attempt to address the bigger problems in the healthcare system. Oh, and the group is launching its own social networking platform for members, a sensible member service move, but hardly a revolution in the making.

As for politically-driven change, meanwhile, MGMA is keeping its hat out of the ring. While it continues to lobby federal legislators on burning issues like Medicare payment levels, it hasn't adopted a broad healthcare reform platform, opting for a very broad set of principles instead. "With so many groups putting their ideas out there already, we just felt that we couldn't add a lot to the discussion," Jessee said.

Who knows, maybe at MGMA's 2009 annual conference the air will be electric with change. But in the meantime, it seems like "watch and wait" are the words of the day. - Anne