HJLR May/Jun 2019

Healthcare Journal of LITTLE ROCK I  MAY / JUN 2019 31 Can you give us an overview of Arkan- sas MGMA and how it serves providers at the local level? Arkansas MGMA is an affiliate of the national MGMA organization. The mission is to empower practices, providers, and patients to create meaningful change in healthcare. The state association focuses on education, experiences, and networking for practice administrators across the state. The cur- rent association membership participation includes rural practices, system-owned prac- tices, physician practices, academic practice, and more. Are revenue strategies changing for medical group providers? With changes to reimbursement, prac- tices are looking to expand existing service lines, capturing the opportunity to expand the depth of their practices with existing patient base. One strategy is to provide specialty clin- ics within a primary clinic, which results in fewer external referrals. The various quality programs from Medicare and Medicaid are continuing to push medical groups slowly to a value-based reimbursement model. We hope that patient interactions will become less transactional and more of an ongoing relationship, based on the newmodel. As this continues, we see practices leveraging more physician extenders, such as nurse practi- tioners, and even some non-traditional staff, such as dieticians, to manage their patient populations with stable, chronic conditions, allowing the physician staff to treat more complex patients.   What merger trends are provider groups working towards? Are you see- ing more affiliations with other provider groups? Medical group mergers with healthcare systems continue as established physician groups look for stability from the chang- ing payment and regulatory landscape, and new physicians are increasingly favor- ing an employment model, leading to less new physician owned practices in market. There is a great shift toward CINs andACOs. Primarily, it’s because of the shift toward value-based reimbursement and the fact that it is no longer based on the care pro- vided by one individual. The value is reli- ant on care provided by multiple providers, clinics, and/or facilities; therefore, it is nec- essary to develop collaborative approaches to care. If each will be affected by the pay- ment, then all want to have a say or at least a role to play. Are Arkansas’ medical groups unique compared to groups around the nation? Since reimbursement trends forArkansas payers trail behindmore metropolitan areas, Arkansas medical groups have enjoyed fewer competitive challenges. Except for the more densely populated areas, compe- tition for patients does not seem as intense in Arkansas. In most areas of the state we are dealing with a rural population, which presents some unique challenges, but noth- ing that other rural states don’t also have to deal with. Our state’s consistently poor rankings for population health may present more of a challenge for the state’s providers. What are some cost-control trends you are noticing in medical groups? From my perspective, it is about under- standing your practices’cost structures and what drives them. I’m paying particular attention to labor costs, such as overtime, by making sure that the practice is adequately staffed and trained, and removing as many inefficiencies from the process as possible. Another cost-control trend is how to save on HER that are needed to adapt to value- based models. This might include EHRs that can integrate seamlessly, or population- health management. “Medical group mergers with healthcare systems continue as established physician groups look for stability from the chang- ing payment and regulatory landscape, and new physicians are increasingly favoring an employment model, leading to less new physician owned practices in market.”