DENVER — Physicians may not be enamored of Medicare, but they like it a whole lot better than private insurance plans, according to a survey by the Medical Group Management Association.
MGMA's Payer Performance Study—covering more than 1,700 group practices—showed that physicians groups ranked Medicare Part B well ahead of six of the largest private insurance companies in terms of overall satisfaction. The organization released the data at its annual meeting.
The survey asked participants, all of whom were members of MGMA, to rank seven of the largest payers—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.
Medicare led the pack with a mean aggregate satisfaction score of 3.59 on a 6-point scale (1 = totally dissatisfied, 6 = completely satisfied). Aetna took second place with a score of 3.14.
The big loser? UnitedHealthcare, with a score of 2.45.
Medicare scored particularly well on the amount of time it takes to respond to questions from physicians or practice managers, the accuracy of its responses, and transparency in disclosing fee schedules and reimbursement policies.
The respondents were much less satisfied with Medicare's provider credentialing processes. On that measure, the Medicare ranked last, with Aetna and Anthem taking first and second place. “The Medicare credentialing process is completely out of synch with that of the private payers, and it is a problem,” said Dr. William Jessee, president and chief executive officer of MGMA.
Dr. Jessee said that the data show particularly strong member dissatisfaction with the private insurers on the matter of negotiating contracts. “MGMA members feel there is disproportionate power on the side of the payers.”
Although Medicare may have scored better than the private insurers, the scores suggest there's much room for improvement in the federal program. Dr. Jessee said that the MGMA survey deliberately did not ask about satisfaction with actual reimbursement rates, but he anticipated that Medicare's relatively favorable ranking could drop considerably if the federal government goes forward with its proposed 21% physician fee cuts next year.
The fee-shearing is among a number of federal-level issues on which MGMA is taking action. “We have three major tasks: repeal the sustainable growth rate [SGR] formula as outlined in HR3200 and most other bills; create a reimbursement formula that accurately reimburses physicians for their actual costs; and simplify administrative transactions,” he said.
Medical group operating costs have been increasing at a rate of 6.5% per year, on average, for the last decade, yet Medicare reimbursement has been flat. That, said Dr. Jessee, is making it difficult for many groups to stay in business. Any further cuts in fees will likely discourage many doctors from continuing to participate in Medicare.
MGMA is committed to fighting the cuts and repealing the SGR formula, and the group has made some progress in Washington, but “there's a lot more game to be played,” he said.