Every 12 months the Scientific Workforce Control Affiliation (MGMA) publishes a document highlighting the perceived burden related to prior authorization and the Medicare High quality Cost Program (QPP). As in earlier years, the survey respondents see the weight getting worse. 

Within the MGMA’s 2023 Annual Regulatory Burden Record, prior authorization necessities as soon as once more ranked as the highest burden for scientific practices with necessities stemming from audits and appeals coming in 2nd, and Medicare’s QPP coming in 3rd. 

The survey contains responses from executives representing greater than 350 staff practices. Sixty p.c of respondents are in practices with fewer than 20 physicians and 16 p.c are in practices with greater than 100 physicians. Seventy-five p.c of respondents are in impartial practices. 

Listed here are a few of the full findings:

• 90 p.c of respondents reported that the full regulatory burden on their scientific follow had larger over the former twelve months.
• 97 p.c of respondents agreed a discount in regulatory burden would permit their follow to reallocate sources towards affected person care.
• 77 p.c of respondents say that regulatory/administrative burden affects present and long run Medicare affected person get admission to.

Prior authorization key findings: 
 
• 89 p.c of respondents rated prior authorization necessities as very or extraordinarily burdensome.
• 97 p.c of respondents reported their sufferers have skilled delays or denials for medically important care because of prior authorization necessities.
• 92 p.c of respondents have employed or redistributed personnel to paintings on prior authorizations because of the rise in requests.

The High quality Cost Program (QPP) created two new reporting pathways to become care supply for Medicare beneficiaries by means of incentivizing the best quality care: the Benefit-based Incentive Cost Machine (MIPS) and Complex Selection Cost Fashions (APMs).

In 2023, 69 p.c of respondents are taking part in MIPS. MGMA stated that it’s in most cases noticed as a posh compliance program that specializes in reporting necessities quite than an initiative that furthers top of the range affected person care. 

CMS presented MIPS Worth Pathways (MVPs) for voluntary reporting in 2023 to additional transition practices into value-based care preparations. 11 p.c of practices replied that they’re these days reporting beneath an MVP, whilst 89 p.c document no longer voluntarily reporting beneath an MVP because of both no longer having an MVP clinically related to their follow, opting for to proceed beneath conventional MIPS, or no longer figuring out MVPs.

QPP key findings: 
 
• 72 p.c of respondents reported that the transfer towards value-based cost projects (in Medicare/Medicaid) has no longer advanced the standard of maintain their sufferers.
• 94 p.c of respondents reported that the transfer towards value-based cost projects (in Medicare/Medicaid) has no longer lessened the regulatory burden on their follow.
• 68 p.c of respondents reported that the transfer towards paying physicians in line with price has no longer been a hit to this point.
• 94 p.c of respondents reported that sure cost changes don’t duvet the prices of time and sources spent making ready for and reporting beneath the MIPS program.
• 78 p.c of respondents reported that Medicare does no longer be offering an Complex APM this is clinically related to their follow.