Medical groups grapple with big challenges

I'm looking forward to going to the Medical Group Management Association conference in Philly next month, and possibly connecting with some of you. The business issues faced by medical practices never hold still, but it's a particularly interesting (dangerous?) to be a practice manager, CEO or even individual practitioner. A lot of things are in flux.

I'd expect that much of the chatter in the hallway, not to mention the sessions, will focus on the following:

Pay for performance: Over the next year or two, P4P schemes are going to touch virtually every physician, through Medicare if nowhere else. Getting prepared for this, which includes not only process changes but also some technology investments, should be a front-of-mind challenge.

Implementing electronic medical records (EMRs):  While big practices are rolling out EMRs left and right, small and mid-sized practices haven't gotten there yet, due largely to the cost of getting started. But adopting EMRs is increasingly becoming a requirement of doing business, where it once was an interesting option.

Physician rating schemes:  Physicians are already looking at having quality data publicly reported in many states--but in those cases, officials are largely allowing the data to speak for itself. Now, health plans are combining this kind of information with pricing and other factors to produce a physician "rating." This will definitely be a concern for practices going forward.

Retail clinics: Rightly or wrongly, many physicians are concerned about the emergence of some clinics, with some arguing that they pose some risks to patients. If I were a doctor or practice manager, I'd be eager to discuss the competitive and clinical challenges posted

Of course, there's a myriad of additional issues medical groups are chewing over, but in my view, these are the ones that seem the most likely to create disruptive changes in the near future.

What other physician practice issues should I keep an eye on when I mingle at the MGMA show?  Please feel free to let me know.- Anne