Turnaround time for medical groups

A big hello to all from the Medical Group Management Association annual conference in Philadelphia. As usual, there's an embarrassment of information on display-a 100 foot knowledge buffet-but a few themes seem to be emerging nonetheless. Today, one of my big show takeaways has been that there's some real shifts going on in how medical groups make their money-but that none of them seem to be clear winners as of yet.

As we note elsewhere in today's issue, new MGMA research has concluded far too many medical groups are finding that expenses are outstripping costs (with the notable exception of pediatrics practices). This simply isn't a sustainable situation.

In the mean time, how are groups coping?  For one thing, they're going retail, with some dispensing prescriptions and others selling practice-related items (think shoes on display in a podiatrist's office). Primary care doctors are charging new fees of one kind or another, or offering new high-ticket cosmetic procedures. Some larger, better financed groups are investing in IT to help them meet pay-for-performance requirements. And of course, there's always lobbying for more favorable Medicare reimbursement schedules, an ever-popular dance.

Though pay-for-performance strategies may have the most upside, I doubt these strategies alone will be enough to sustain financially-troubled medical groups. It seems likely that groups will have to go more vigorously (to the extent allowed by law) into higher-margin efforts like closer physician-hospital profit-sharing, accelerated investment in ambulatory care centers and freestanding physician-owned hospitals. For primary care groups at least, opening retail clinics is a possibility as well, though to be honest, I haven't heard any PCPs propose the idea.

What strategies do you see emerging that might help physicians turn their financial picture around?  Are these ideas going to do it, or will it take something else, and do you know what it is? I'd love to hear your ideas.-- Anne

Meanwhile, seen and heard on the exhibit floor:
* A GE marketer tells me how he's communicating the value of electronic medical records to the show, using podcasts and short video "tours" of physician offices using EMRs. "We just take go there and show doctors what it's like," he said.

* Workflow.com offers up a tiki bar, complete with faux flaming torches, plying happy exhibit goers with drinks (and of course, pitching demos of its EMR).

* RelayHealth booth workers wear human-sized prescription pad and fax machine costumes, waving at the crowd and posing for instant snapshots with conference attendees. (The company also gave away some adorable stuffed fax machine and prescription pad toys which my children are sure to love…)

* A teenaged shriek comes from the mouth of a grandmotherly practice administrator when she learned that she'd won an Xbox 360 for participating in NextGen's edu-tainment game. Pretty slick, guys. You even got me to attend the presentation twice!