ACOs dominate early discussion at MGMA conference

By Eric Wicklund
10:15 AM

The Medical Group Management Association kicked off its 2011 Annual Conference on Sunday with an odd occurrence: Good news coming out of Washington D.C.

During the organization’s “MGMA Open Mic Live!” session – the first public session in the three-day conference being held at the Las Vegas Convention Center – directors fielded the usual complaints and concerns from members about issues ranging from ICD-10 to physician integration with hospitals. But they also took the time to praise the Department of Health and Human Services for last week’s release of the final rules for Medicare accountable care organizations.

“(HHS) did a better-than-average job of addressing the concerns that we addressed,” Anders Gilberg, MGMA’s senior vice president of government relations, told an audience of roughly 150 people.

Those concerns were raised when HHS released its proposed rule this past spring, which Gilberg said “fell with a thud.”

Gilberg specifically cited three changes in the final rule that pleased MGMA officials. He said financial incentives for physician groups to invest in an ACO have increased; hospital-based quality measures have been removed, so as to allow group practices to support an ACO without establishing a formal relationship with a hospital; and a requirement has been removed that would have forced all ACOs to become risk-sided by the third year of the first three-year contract.

“It’s a step off of fee-for-service,” Gilberg pointed out. “Will it work? I still think it will be challenging.”

The revised ACO rules are expected to dominate several sessions over the next two days, including a presentation this morning by National Coordinator for Health IT Farzad Mostashari, MD.

Gilberg was joined on the stage by MGMA Board Chairwoman Shena Scott, who is director of Melbourne, Fla.-based Brevard Anesthesia Services, P.A.; and MGMA Board Chairman Alan Winkler, vice president of clinical operations for the Little Rock, Ark.-based St. Vincent Health System. Moderating the discussion was Susan L. Turney, MD, the organization’s new CEO and president.

Turney said she’s ready for the challenges that lie ahead and hinted that the MGMA would soon be releasing a new strategy focusing on HIT.

In response to a question of why the MGMA hasn’t lobbied Congress to ditch the impending transition from ICD-9 code sets to the much more complicated ICD-10 code sets, Gilberg and Robert Tennant, the organization’s senior policy advisor for government affairs, said the MGMA has worked closely with government officials to ensure that physicians aren’t overwhelmed in the transition.

“It’s difficult to argue against ICD-10 because there are some significant quality improvements associated with it,” Tennant pointed out.

Tennant did warn that many physicians are “behind the curve” in preparing for the HIPAA 5010 transition, and said the MGMA is pressing CMS to develop a contingency plan should a majority of practices not be ready by the time the new codes take effect.

Then, with an exhibit hall filled with vendors a few hundred feet away, Tennant delivered an IT challenge.

“The question is, will the vendors step up and produce the software that will allow you folks” to be ready on time, he said.

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