DENVER — For all the blather these days about how much doctors hate “government sponsored health care,“ it seems that they prefer it to the big private for-profit insurers.
That’s the conclusion to be drawn from the Medical Group Management Association’s new Payer Performance Study—a survey that asked more than 1,700 group practices detailed questions about their treatment at the hands of various payors.
The data, released at the MGMA’s annual meeting in October, showed that physicians groups rated Medicare Part B considerably better than six of the largest private insurers.
Survey participants, all of whom were members of MGMA, were asked to rank Medicare Part B, UnitedHealthcare, Aetna, Cigna, Humana, Coventry and Anthem on parameters including payer communications, provider credentialing, contract negotiation, payment processing, systems transparency, and overall satisfaction.
In terms of overall satisfaction, Medicare was the clear winner, with a mean aggregate score of 3.59 on a 6-point scale (1=totally dissatisfied, 6=completely satisfied). Aetna was second with a total score of 3.14. The group practices’ least favorite plan? UnitedHealthcare, with an aggregate score of 2.45.
The Fed ranked particularly high on measures of speed in responding to questions from physicians or practice managers, the accuracy of their responses, and transparency in disclosing fee schedules and reimbursement policies.
Group practices are particularly disgruntled with the process of negotiating contracts with private payors, voicing a strong sense that the payors have disproportionate power in setting terms, said William Jessee, MD, president and CEO of MGMA, analyzing the findings.
While Medicare may have bested the privates in this survey, the findings should not be misconstrued as a love note to the Fed. Dr. Jessee said respondents expressed extreme dissatisfaction with Medicare’s practitioner credentialing process, which is highly problematic and out of step with that of the privates.
MGMA’s survey deliberately does not ask about satisfaction with actual reimbursement rates–the objective was to tease out differences in how the plans actually interact with physicians’ groups.
On the matter of reimbursement, Medicare is hardly beloved among physicians, and if the government does enact it’s proposed 21% fee cuts in 2010, physician dissatisfaction with the federal program is likely to soar.
Medical group operating costs have been rising at rate of 6.5% per year, on average, for the last decade, but Medicare payment rates have been flat. Many practices are already hanging by a thread, and further pay cuts could kill some practices, while discouraging others from participating in Medicare.
That could be very problematic at a time when more than 87 million Americans—29% of the total population—are getting medical coverage through a federally funded plan. According to a new survey of 178,000 physicians’ offices by SK&A, a health care trends research company, only 83% of all practices currently accept Medicare, and 65% accept Medicaid.
Larger practices (26 doctors or more), those with high patient volume (more than 30 patients per day), and practices owned by hospitals are more likely to accept Medicare/Medicaid than smaller, lower-volume, independently owned practices.
Interestingly, SK&A found that among physicians who self-designate as practicing “holistic medicine,” only 23% accepted Medicare.
Dr. Jessee said his organization is committed to fighting the proposed fee cuts and repealing the much-despised Sustainable Growth Rate formula as outlined in HR3200 and most other reform bills. MGMA is pushing for, “a reimbursement formula that accurately reimburses physicians for their actual costs,” he said.
