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Tue, Oct 13 2009 5:36 PM EST
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Here’s a man-bites-dog story for you: Physician practices are pretty happy with the way health plans are performing on a number of administrative measures.
MGMA recently surveyed its members on how satisfied they are with how quickly their plans pay claims and the mean score was roughly equivalent to a B+.
ll;">How willing the insurer is to fork over details of the fee schedule under which they pay doctors: A-.
Their favorite payer: Medicare. Aetna and Cigna were second and third. That’s the overall ranking; Medicare came in dead last when ranked on provider credentialing.
“Even though Medicare consistently underpays and places member practices in an increasingly difficult financial situation, our members are positive about how the Medicare program is administered,” says William Jessee, M.D., MGMA’s president and CEO.
This is the second year of the survey, which asks group practice managers’ attitudes about payer interactions. Seven payers were rated: Aetna, Anthem, Cigna, Coventry Health, Humana, Medicare Part B and UnitedHealthcare. The study focused on satisfaction with payer communications, provider credentialing, contracting, payment policies, system transparency and overall satisfaction.
Standardized and transparent administrative processes generated high satisfaction scores. Medical groups universally said they are frustrated with the claims denial appeals process, contract negotiations and ratings system transparency. Medicare’s poor showing on physician credentialing apparently results from the government’s refusal to participate in the standardized physician credentialing system (called CAQH Universal Provider Datasource) that’s widely used in the private sector.
There may be a punch line to this story after all. The study didn’t address medical groups’ satisfaction with how well their insurers paid them. And ranking dead last in insurer ratings: How much leverage the group practice has during contract negotiations.
Rick Haugh is an H&HN contributing writer blogging live from MGMA 2009 Conference.
