Practice executives' satisfaction with seven major health plans has mostly increased; however, payers aren't offering many innovative payment models - such as accountable care and payment bundling - that are favorable for the practices.
Practice executives’ satisfaction with the seven major national health plans mostly increased over the last six months, driven mostly by accurate and consistent communications, according to research by MGMA-ACMPE.
The survey focused on seven large, national payers: Aetna, Anthem, CIGNA, Coventry, Humana, Medicare Part B and United Healthcare.
Overall satisfaction with only one of the seven large payers, United Healthcare, went down over the past six months. For the rest of the payers, satisfaction went up, with Medicare Part B showing the largest rating average increase from 2.96 to 3.53. Six months ago, none of the payers had a satisfaction rating over 3; however, this current survey put satisfaction over 3 for four of the payers.
“Our members work with payers on a daily basis, and identifying areas of improvement is paramount,” Susan Turney, MD, MS, FACP, FACMPE, MGMA-ACMPE president and chief executive officer, said in a statement. “It’s mutually beneficial to keep lines of communication open, and for our members and the payer community to cultivate deeper relationships. Ultimately, these interactions may result in less distraction and resource diversion from practices’ primary focus, the needs of their patients.”
Nearly 800 respondents participated in the poll, offering perceptions of the payer environment in areas of payer communications, provider credentialing, contracting, payment policies, system transparency, overall satisfaction and their willingness to engage in innovative payment models.
There were only two questions out of 13 where all of the payers received satisfaction ratings over a 3.
How willing is the payer to disclose the fee schedule used to reimburse your practice under the terms of your contract?
How satisfied are you with the promptness of claims payments?
Unfortunately, there were four questions where all payers received less than a rating of 3:
How satisfied are you that the payer conducts two-way, good-faith negotiations during the contracting process?
How transparent to you are the cost and quality measures used by the payer for its physician rating and/or pay-for-performance program?
How willing is the payer to engage in innovative payment models or offer new/innovative contracts based on concepts such as accountable care, shared savings, medical homes or payment bundling?
Of the payers who are willing to engage in innovative payment models, how favorable or unfavorable do you consider these options to be to your practice?
“It’s important for our members not to rush into new models if they aren’t beneficial for their patients and practices,” Turney said. “Aligning the incentives for practices, patients and payers will be key for these types of arrangements to be successful moving forward.”