MGMA Report Reveals First-Ever Data on Operational Evolution to Value-Based Care for Medical Practices

Ongoing hurdles in scheduling, reimbursement and collections compound difficulties for a healthcare industry already under stress

ENGLEWOOD, Colo., Aug. 18, 2022 /PRNewswire/ -- Medical Group Management Association (MGMA) released a report detailing new benchmarks related to the adoption rate of value-based reimbursement. The 2022 edition of MGMA DataDive Practice Operations includes data from more than 2,300 organizations across multiple specialties and practice types. The data reveals key performance indicators related to operational challenges affecting patient engagement and financial resilience for medical practices. With an accelerating emphasis on value-based care, a growing number of practices are experiencing revenue benefits from engaging in this approach while other practices have yet to realize the potential of engaging in value-based care.

For deeper data analysis, MGMA created the data report, "Patient Access and Value-Based Outcomes Amid the Great Attrition." Its findings build upon new MGMA DataDive benchmark data, including recent MGMA Stat polling of frontline healthcare leaders on ongoing challenges to ensure prompt patient access and quality care outcomes as the shift to value, stalled slightly during the COVID-19 pandemic, picks up steam.

MGMA's first-ever distributed benchmarking data shows that the average rate of value-based care only accounts for approximately 5.5% to 14.74% of revenue, with primary care and surgical specialties reporting lower revenue shares from value-based contracts in 2021 and nonsurgical specialties attributing 14.74% of total medical revenue to value-based contracts. The data also details the impact on appointment schedules from a surge in patient demand amid staffing shortages, with key performance data on no-show rates, cancellations and wait times.

"The medical workforce is grappling with burnout, staffing declines, decades-high inflation, operational challenges and a dynamic reimbursement environment that affects providers across the board," said Halee Fischer-Wright, MD, MMM, FAAP, FACMPE, president and chief executive officer of MGMA. "This report reveals how addressing scheduling errors and billing denials could help relieve the financial burden on health groups, moving them toward value-based care that promotes the welfare of physicians, staff, and patients."

MGMA's "Patient Access and Value-Based Outcomes Amid the Great Attrition" report includes enhanced analysis of this data. Key findings include:

• The median revenue amount across all practices from value-based contracts was $30,922 per full-time equivalent provider.
• Overall patient portal usage improved from 2020 to 2021, with a significant increase in patient logins.
• The percentage of practice claims denied on the first submission doubled across primary care, nonsurgical and surgical specialties.
• The return of patient volume in 2021 led to shifts in appointment scheduling benchmarks, as higher demand for care saw no-show rates hold steady and an uptick in cancellation rates.

The report includes additional findings on the burdens of prior authorizations, the appointment creation process and extended payment posting and collection timelines. Download the data report for more in-depth analysis and reporting.

Healthcare leaders have an opportunity to receive additional insights into value-based care at MGMA's upcoming Medical Practice Excellence: Leaders Conference, taking place October 9-12, 2022, in Boston, Massachusetts. MGMA will share key insights into new benchmarking data and more high-priority topics that are critical to the success of medical practices across the country.

Founded in 1926, the Medical Group Management Association (MGMA) is the nation's largest association focused on the business of medical practice management. MGMA consists of 15,000 group medical practices ranging from small private medical practices to large national health systems representing more than 350,000 physicians. MGMA helps nearly 60,000 medical practice leaders and the healthcare community solve the business challenges of running practices so that they can focus on providing outstanding patient care. Specifically, MGMA helps its members innovate and improve profitability and financial sustainability, and it provides the gold standard on industry benchmarks such as physician compensation. The association also advocates extensively on its members' behalf on national regulatory and policy issues. To learn more, go to MGMA.com or follow us on LinkedIn, Twitter and Facebook.

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SOURCE Medical Group Management Association