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November 17, 2021
David Burda
Economics Outcomes Policy

Same Old, Same Old When It Comes to What Doctors Don’t Like

I’m late to the party on this one, but it’s a topic I like, so I’m going to comment on it anyway. 

The Medical Group Management Association released its latest annual regulatory burden report in late October, and guess what, doctors still don’t like being told what to do, especially by health insurers and other payers like Medicare and Medicaid. You can download the 12-page report here.  

To some, the fact that not much changes year to year in the annual MGMA regulatory burden reports may not be news. To me, that is the news. Physicians are consistent in their utter loathing of rules and regulations that tell them how to run their practices and treat their patients if they want to get paid. 

Not even a global pandemic changed how doctors feel as MGMA didn’t do a regulatory burden survey last year because their medical practice members were busy with COVID-19. No matter. Loathing is loathing. 

Here are the top five non-COVID-related regulatory issues that drew physicians’ ire this year, based on a survey of executives from more than 400 medical group practices:

  1. Prior authorization, cited by 88 percent of the survey respondents as “very” or “extremely” burdensome
  2. Medicare Quality Payment Program (MIPS and APMs), cited by 71 percent of the survey respondents as “very” or “extremely” burdensome
  3. Audits and appeals, cited by 65 percent of the survey respondents as “very” or “extremely” burdensome 
  4. Medicare Advantage chart audits, cited by 60 percent of the survey respondents as “very” or “extremely” burdensome
  5. Lack of EHR interoperability, cited by 56 percent of the survey respondents as “very” or “extremely” burdensome

As for COVID-related regulatory requirements, medical practices didn’t like those either. Seventy-one percent said COVID-19 workplace mandates were “very” or “extremely” burdensome this year, while 67 percent said the same thing about COVID-19 provider relief fund reporting requirements. 

In 2019, or pre-COVID, the top five regulatory issues cited by the surveyed physicians as “very” or “extremely” burdensome were virtually the same as this year: 

  • Prior authorization (83 percent)
  • Medicare Quality Program (MIPS and APMs) (77 percent)
  • Audits and appeals (67 percent)
  • Lack of EHR interoperability (65 percent)
  • Medicare Advantage chart audits (61 percent)

We wrote about the 2019 survey results in this blog post two years ago: “Ranking the Regulations that Bother Doctors” 

The question then becomes, is being consistent about what you don’t like good or bad if you’re a medical practice?

On one hand, being consistent lends credibility to your position, which may help you push forward with your regulatory agenda. You’re resolved. You’re steadfast. You’re not hopping all over the place and making the relief you want a moving target for regulators and lawmakers.

On-the-other-hand, being consistent may make it easier for regulators and lawmakers to turn a deaf ear to what you want. They may tune you out because it’s the same old, same old each year. Yeah, yeah, PA, quality reporting, blah, blah, blah.  

I don’t know the answer as I’m not a regulator or lawmaker or lobbyist.

But I am a husband and father. I’ve also been an employee and a manager. Sometimes I do something  just because I’m tired of hearing about it. Sometimes I won’t do something just because I’m tired of hearing about it. And, yes, sometimes I do something because I think it’s the right thing to do. 

Will medical practices get the regulatory relief they seek and be happy? We’ll know when next year’s MGMA regulatory burden report comes out.

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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