Five Closing Thoughts from MGMA17

Welcome to Editor's Corner. Here, the editors of Physicians Practice will share their thoughts on the happenings in healthcare and look at the industry from a broader viewpoint.

As I write this, the screen in front of me says I'm 36,981 feet in the air and view from my seat is nothing but clouds and mountainous rock formations.

I'm heading back east after a 3-day whirlwind of a trip to Southern California and the annual Medical Group Management Association (MGMA) conference. While I wish I could have stayed longer, I feel confident enough to say I was in the Anaheim Convention Center long enough to form lasting thoughts and observations on the event and last few days.

Here are five in particular:

1. MACRA Madness: I talked about this with MGMA's CEO and President, Halee Fischer-Wright, MD on our Facebook Live video. The theme of this year's MGMA show was "empowerment," but it's clear that many physicians and practice managers feel anything but empowered. They feel overwhelmed and buried by government regulations.

This was especially clear at a session on Medicare's Quality Payment Program and the Merit-based Incentive Payment System (MIPS) with Kate Goodrich, MD, Director and CMO of CMS. The contentious questions attendees asked Goodrich exemplified that many are frustrated. In particular, they're upset with the lack of clarity from CMS about the data submission process for MIPS and the final measures for the 2018 performance year, as well as limited options for participation in advanced alternative payment models, and much more.

If CMS wants to win back the hearts and minds of physicians, administrators, and any other practitioner, they have a long ways to go. One question-asking attendee even suggested the lost productivity from MIPS would cost some practices billions - yes billions with a B.

2. Good Advice: Staying on the topic of CMS and MIPS, Dr. Goodrich had some valuable advice for physicians, administrators, and anyone affected by MIPS: "When you give [CMS] feedback, get as specific as you can, especially with things we can weigh." She also predicted from year one to year two, practices will likely not see a significant shift in MIPS' category measures (improvement activities, advancing clinical information, and quality).

3. Value: One of the most important sessions I attended at MGMA17 was with Michael Cuffe, MD, HCA Healthcare, on the evolution and transition to value-based care and risk. He made very salient points about the reality of taking on risk. In essence, it's really, really hard and most practices are not currently set up to succeed in this environment.

"If you're a small [practice] looking to make money, watch out. [Switching to a value-based model] is not easy. This is more like rocket science. The tools are not often there," he warned. Specifically, he talked about the investments needed in EHR infrastructure, unlike anything done before. It also will be a "generational change" for physicians who have been trained in years and years of fee-for-service medicine.

He offered advice to those looking to go down this path: "Think about what you have to do to succeed. Think about your health system partner. Be sure your physicians know what they're getting themselves into." 

4. Some Ups, Some Downs: Throwing a conference has to be hard because if there are more than two people attending it, you're bound to upset someone. Some people enjoyed the opening keynote from actress Viola Davis (including me), others thought it was too depressing. Davis focused on her tough upbringing and how she overcame it to become an Academy Award winning actress. Some people wanted the exhibit floor to open at 6:30 a.m., many others were not as happy about waking up before the sun came up. You can't please everyone.  

5. California Wildfires: One of the more surreal moments of the conference was stepping outside at 12 p.m. on Monday to a dreary, smoke-filled Southern California day. As many reading this know, both Northern and Southern California have been plagued with an epic drought, which coupled with high winds, has created dangerous wildfires in various areas of the state. One particular wildfire formed in the Anaheim Hills, not too far from the Anaheim Convention Center. As an east coaster, it was downright bizarre (and somewhat frightening) to smell smoke and get hit with ash when walking outside.

As the fires continue to blaze and affect thousands of lives, all I can say is stay safe California! Thanks for being a great host!