When the Medical Group Management Association recently asked its members about some of the regulatory burdens they’ve experienced, one question was about the Stark Law Anti-Kickback statute. Formally known as the Physician Self-Referral Act, it prevents doctors from referring patients in whom there are financial interests or investments.
The law itself appears cut-and-dried, though like many regulations, there are complexities attached. There were two slight extremes in MGMA’s survey results: At least 15 percent of the MGMA’s 425 medical group practices who filled out its survey said they had no problem with the regulation, saying it was not burdensome. Yet, at least 32 percent said it was extremely burdensome.
Depending on someone’s view, the regulations involving the Stark Act may appear to be troubling – with at least one-third of the doctors seeing it that way.
But there’s another pressing issue that the results showed. Of all the questions about regulations that the MGMA posed, the one about the Stark Act showed a response that basically said:
Hey, this is an easy regulation.
Indeed, MGMA’s members found other regulations far – far – worse than the Stark Act.
Overall, the medical groups say that wasteful regulatory burdens are driving up too many costs and generating too much of their time that they say could be better spent on patient care. In some cases, the regulations continued to worsen over the past year.
When asked in the survey about “how burdensome would you rate each of the following applicable regulatory issues,” the respondents were overwhelming in saying they were either “very or extremely burdensome:”
The worst — Medicare Quality Payment Program (MIPS/APMs) – 88 percent. MGMA officials said that “ranked as the most burdensome issue” and “little clinical benefit.”
- Prior Authorization – 82 percent.
- Lack of electronic health record “interoperability.”– 80 percent.
- Government EHR requirements – 77 percent.
- Audits and appeals – 68 percent.
The findings were included in the so-called 2018 Regulatory Burden Survey at MGMA18, the annual conference. MGMA includes 40,000 medical practice administrators, executives and healthcare leaders. The organization says it represents more than 12,500 organizations that deliver almost half of the healthcare in the U.S.
- A vast majority – 86 percent – of respondents “reported the overall regulatory burden on their medical practices has increased over the past 12 months,” MGMA said. Even more respondents – 94 percent – agree that a “reduction in regulatory burden” would allow their practices to reallocate resources toward patient care, according to the organization.
“This precipitous increase in regulatory burden over the past 12 months should alarm policymakers,” said Anders Gilberg, senior vice president of federal affairs. “MGMA’s survey provides valuable insight into what’s ailing medical practices.”
As healthcare moves toward value-based payment, a “staggering 90 percent” of those surveyed reported that it resulted regulatory burden increases on their practices, MGMA said. And 76 percent said it did not improve the quality of care delivered to patients.
As far as the doctors see it, the regulations rumble ahead.
Gilberg has hope. He says MGMA’s findings “will enable HHS (Health and Human Services) to refocus and redouble its efforts to create meaningful regulatory relief for physician practices.” — Joe Cantlupe