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October 26, 2022
David Burda
COVID-19 Outcomes Policy

More Than Three-Quarters of Medical Practices Say Provider Consolidation is Bad for the Industry

I do love the annual regulatory burden survey report from the Medical Group Management Association. Why? Lots of reasons. I’m a cranky businessman, so I can relate to the administrators who run medical practices. Philosophically, I prefer competition to regulation. I like repetition, and annual reports on the same topic that come out the same time feed by fetish. And I like longitudinal studies that ask the same questions year after year so I can compare apples to apples and come up with a blog post topic.

Enough about me. Let’s talk about what’s bugging the more than 500 medical practice administrators, executives and leaders who responded to this year’s survey. You can download the survey report here.

Overall, the hatred of federal regulations and the burden they place on medical practices is down a few degrees. This year, 89 percent of the respondents said the regulatory burden on their practices went up over the past 12 months compared with 91 percent of the respondents who felt the same way in 2021.

Prior authorization continued its long reign as the regulatory burden that bothers medical practices the most. Eighty-two percent of this year’s respondents said prior auth was “very” or “extremely” problematic. That’s down from 88% in 2021 but still the No. 1 regulatory headache experienced by medical practices.

There is a new No. 2, though, and that’s the government’s new surprise billing and good-faith estimate requirements, which are part of the No Surprises Act that went into effect on Jan. 1. (MGMA did not ask this question in previous surveys as it’s a new law.)

Seventy-four percent of the survey respondents said they don’t have the technical infrastructure to comply with provisions of the law, and 82 percent said the provisions in the law have increased the administrative burden on their practices. Similar to how hospitals reacted after the new hospital price transparency rules went into effect on Jan. 1, 2021.

Of particular interest to me was how the respondents said they felt about healthcare consolidation. Like I said at the start, I prefer competition to regulation. The lack of state and federal antitrust enforcement has all but eliminated provider competition in most markets across the country because most providers have been able to merger with and acquire each other with little fear of being stopped.

Some 90 percent of the respondents said healthcare consolidation is increasing, and 78 percent said consolidation has had an overall negative effect on the healthcare system. Ouch.

If you’d like to learn more about this topic, please read “Same Old, Same Old When It Comes to What Doctors Don’t Like” on 4sighthealth.com.

I’m already looking forward to next year’s MGMA survey!

Thanks for reading.

About the Author

David Burda

David Burda began covering healthcare in 1983 and hasn’t stopped since. Dave writes this monthly column “Burda on Healthcare,” contributes weekly blog posts, manages our weekly newsletter 4sight Friday, and hosts our weekly Roundup podcast. Dave believes that healthcare is a business like any other business, and customers — patients — are king. If you do what’s right for patients, good business results will follow.

Dave’s personnel experiences with the healthcare system both as a patient and family caregiver have shaped his point of view. It’s also been shaped by covering the industry for 40 years as a reporter and editor. He worked at Modern Healthcare for 25 years, the last 11 as editor.

Prior to Modern Healthcare, he did stints at the American Medical Record Association (now AHIMA) and the American Hospital Association. After Modern Healthcare, he wrote a monthly column for Twin Cities Business explaining healthcare trends to a business audience, and he developed and executed content marketing plans for leading healthcare corporations as the editorial director for healthcare strategies at MSP Communications.

When he’s not reading and writing about healthcare, Dave spends his time riding the trails of DuPage County, IL, on his bike, tending his vegetable garden and daydreaming about being a lobster fisherman in Maine. He lives in Wheaton, IL, with his lovely wife of 40 years and his three children, none of whom want to be journalists or lobster fishermen.

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