From Politics to Practice

What we learned at MGMA. By Gene Boerger, V.P. of Professional Product Management at Emdeon

On the surface, the agenda for the 2012 MGMA annual conference (San Antonio, Oct. 21-24) contained few surprises: Education sessions focusing on ICD-10, ARRA, administrative simplification, Meaningful Use and ACOs.

What was unexpected, however, was the energy invested by more than 3,000 people in attendance in transforming the politics of these issues into actionable strategies. Attendees and vendors alike were eager to convert the principles of reform into practice. We strategized with numerous provider groups to share how our expertise in care management, clinical information exchange and revenue optimization can transform industry concepts into real, workable scenarios. From our viewpoint, attendee interests fell into four major categories:

1. Solution engineering. We spoke with leaders at medical groups who recognize they need new solutions and new processes to achieve their objectives. Educational sessions, hallway discussions and vendor meetings centered on best practices and lessons learned. Attendees seemed to have a grasp of what they need and were tuned in to asking questions about how to get from here to there. Vendors were on the same wavelength. Countless meetings were held outside of exhibitor hours, where discussions about how to collaborate and integrate technologies to provide a more comprehensive whole abounded.

2. Care Management. Discussions about new care and reimbursement models, such as accountable care organizations (ACOs) and other pay-for-performance arrangements, have progressed from the abstract (“these approaches will help us control costs and improve care”) to the concrete (“who needs to be involved and what precisely will they be doing?”). Attendees explored the structures needed for greater focus on care management and heightened levels of coordination among providers. These conversations also dug deep into alignments—particularly as they affect community physicians—with hospitals.

3. Data drivers. As quality measures become engrained in emerging reimbursement models, medical groups increasingly need advanced data collection, analysis and reporting capabilities to successfully participate in a pay-for-performance or ACO-type model. Attendees recognized that their EHRs must work harder and that health information exchange (lowercase) is crucial. With a traditional focus only on delivering care—and not necessarily measuring it—providers are now taking a crash course in what tools are available, how they need to be configured and what they can do with the data that’s produced.

4. Business success. Billing professional fees. Proper coding and revenue optimization. Preparing for (and passing) audits. Contract negotiations. Use of outsourcing and technology. Patient collections. All activities that impact the bottom line—with a plethora of “practice proven and time tested” solutions for the challenges many medical groups face—were widely discussed. To arm our providers with information to improve business success, Emdeon held several educational presentations aimed at increasing revenue while effectively managing operations. Attendees agreed these considerations were more important in 2012 than ever before because of the incentive and payment reduction programs payers have adopted.

Emdeon made its presence felt throughout the conference, joining more than 350 other companies on the trade show floor with a dynamic booth that hosted long-time customers and new prospects. Emdeon was joined by the American Academy of Family Physicians for a speaking engagement in the MGMA Innovation Center on Care Management, and Emdeon representatives also delivered a number of in-booth educational sessions on topics ranging from how to remove barriers to submitting clean electronic orders to revving up cash flow by accepting online payments.

Overall, the mood of MGMA seemed to be of anticipation, partly fueled by the impending presidential election. Many attendees seemed to be of the opinion that the trends spurred by healthcare reform legislation would continue—and that they are embracing and preparing for new directions.

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