Survey: Practices seeing increased regulatory burden

Federal regulation on medical practices has been on the rise over the past year.

According to a news release, the Medical Group Management Association (MGMA) 2021 Annual Regulatory Burden Report found that, among the 420 medical groups that participated, 91 percent report that the overall regulatory burden on their practice had increased over the past 12 months. A further 95 percent of respondents say a reduction in the regulatory burden would allow them to allocate more resources to patient care. The respondents ranked prior authorization requirements as the top burden for medical practices while Medicare’s Quality Payment Program (QPP) and COVID-19 mandates tied for second.

“Medical practices continue to report an increase in regulatory burden, with challenges associated with the COVID-19 pandemic further compounding the issue,” Anders Gilberg, senior vice president of government affairs at MGMA, says in the release. “Practices are currently experiencing unprecedented shortages of clinical and administrative staff, yet the federal government continues to add layer upon layer of new regulatory requirements. Medical groups are reporting that there are barely enough nurses to take care of patients, let alone spend time navigating onerous prior authorization requirements or reporting clinically irrelevant quality measures to Medicare. Regulatory burden is diverting precious resources away from patient care.”

Respondents cited growing challenges with prior authorization such as issues submitting documentation and changing medical necessity requirements. Of the 73 percent of responding practices participating in the Merit-based Incentive Payment System (MIPS) as part of the QPP, 93 percent says that MIPS payment adjustments do not cover to cost of time and resources spent on preparing and reporting under the program, according to the release.

A further 79 percent of respondents say that Centers for Medicare and Medicaid Services’ (CMS’) implementation of value-based payment policies has increased regulatory burden on their practice, while about 90 percent noted the CMS’ feedback on MIPS cost and quality measure doesn’t help with reducing costs or improving outcomes, the release says.

“MGMA’s survey results indicate that most medical groups share CMS’ vision of transitioning into value-based care arrangements,” Gilberg says in the release. “Unfortunately, 80% of respondents reported that there was not an alternative payment model [APM] clinically relevant to their practice. We urge CMS to collaborate with stakeholders in the development of an (alternative payment model) portfolio that meaningfully addresses and transforms patient care.”