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MGMA Survey on Payer Performance

By December 20, 2010Commentary

The Medical Group Management Association represents larger group practices across the country.  It surveys those practices every year to obtain perceptions about various private and public health plans.  In the most recent survey, those plans included Medicare Part B, Aetna, Anthem (WellPoint), Cigna, Coventry, Humana and United HealthCare.  Areas surveyed included communications, credentialing, contracting, payment policy, transparency and overall satisfaction.   (MGMA Survey)

On a 1 to 5 scale, with one being worst and five best, overall satisfaction is highest with Medicare at 3.43, and lowest with United at 2.6; most of the private payers are clustered around 3, which is neutral.  Good thing they didn’t ask about Medicaid!  Payer communication follows the exact ranking of general satisfaction, whereas credentialing finds Medicare last.  There are widespread negative feelings regarding contracting, with most scores in the very low two range.    Most providers, however, are happy with the disclosure of reimbursement amounts, but unhappy with the appeals processes.  In general, promptness of payment seems acceptable.

The private plans get very low ratings on the disclosure of the metrics they use for cost and quality physician rating or pay-for-performance programs.  The results aren’t surprising, other than the general higher satisfaction with Medicare.  What would be interesting is to see how the payers feel about the MGMA’s members’ billing practices and their level of transparency.  Consumers certainly don’t feel they have a clue what physicians charge or how they come up with those charges.

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