High regulatory burdens are taking away from patient care

While the Trump administration has focused on decreasing regulatory burdens across several industries, healthcare participants still see the regulatory environment as highly burdensome, according to a new survey from the Medical Group Management Association. And it may be taking resources away from patient care.

Over the last 12 months, 86 percent of survey respondents said the overall regulatory burden on their medical practice increased, and just 2 percent said it decreased. Another 12 percent stated the burden did not change over that time period. Similarly, 79 percent said the regulatory burden in the Medicare program increased; 19 percent said it didn’t change; and 2 percent said it decreased.

Respondents also overwhelmingly stated (94 percent) that a reduction in regulatory burden would allow a reallocation of resources toward patient care. A reduction in regulatory burden would allow practices to invest in new technology, 78 percent of respondents agreed.

The survey compiled responses from 426 individuals from group practices. MGMA has more than 40,00 members, including medical practice administrators, executives and leaders, representing more than 12,500 organizations in the United States.

“This precipitous increase in regulatory burden over the past 12 months should alarm policymakers,” Anders Gilberg, senior vice president of federal affairs of MGMA, said during a presentation on the survey’s results at the MGM annual conference in Boston.

Of all regulatory issues, respondents most often rated Medicare quality payment program MIPS/APMs as either very or extremely burdensome (88 percent), followed by prior authorization (82 percent) and lack of EHR interoperability (80 percent).

“Interoperability will never be achieved at the rate we’re going without bankrupting most private medical practices,” one respondent wrote. “As each of the EHR vendors moves towards their own interpretation of interoperability, they create different versions of their own software that cost all of us more to implement, and we can’t afford any more.”


Respondents saw a correlation between the ongoing shift away from volume to a value-based care health system and the rise in regulatory burdens. 

When it comes to how medical practices view the move toward value-based payments, 57 percent of respondents said they view the shift as negative, compared to 38 percent that said it was positive. The majority (76 percent) also said the move toward value-based payment in Medicare and Medicaid has not improved the quality of care for patients. The vast majority (90 percent) agreed the value-based shift in Medicare and Medicaid has increased the regulatory burden in medical practices.

Most respondents said they participate in the Medicare Merit-based Incentive Payment System (MIPS), but only 51 percent said the clinicians in their practices understand how the program evaluates their practice on quality. Two-thirds said the MIPS program did not support their practice’s clinical quality priorities.

“The lack of clarity and constant readjusting of the MACRA regulations regarding MIPS/APMs is also frustrating,” one respondent wrote.

With respect to advanced alternative payment models (AAPMs), just 44 percent said they would be interested in participating in one. Roughly one-third of respondents didn’t have an opinion, but 55 percent said Medicare does not currently offer an AAPM that is clinically relevant to their practice.