At the end of October, practice managers from around the country gathered in Nashville for the annual meeting of the Medical Group Management Association. Dr. William F. Jessee, FACMPE, president and CEO of MGMA and its certification body, the American College of Medical Practice Executives, delivered his annual report highlighting accomplishments and concerns impacting the membership. Additionally, the physician outlined the six components of the recently completed strategic plan and unveiled the new, unified mission statement for MGMA and ACMPE, which simply states the association will be driven to continually improve the performance of medical group practice professionals and the organizations they represent. Straightforward in content, Jessee said the short mission statement had become the launching pad for all other efforts. "That mission drives our every effort to make a better future than we have today," he said. "It is the beacon from which we built the strategic plan." Jessee noted MGMA had much to celebrate in the past year. During fiscal year 2005, he reported operating margins reached 8.5 percent and that both ACMPE and MGMA Center for Research exceeded their budgeted operating margins. Additionally, he said, investment earnings added to the bottom line for the second consecutive year. Furthermore, in an era of declining memberships for some organizations, MGMA saw growth both in its membership numbers and in the number of professionals seeking certification. Despite the good news, Jessee said there are many grave concerns within the nation's healthcare industry that must be addressed. "Our healthcare system is sick," he stated flatly to the audience. "All of you are familiar with the symptoms," he continued. Jessee went on to say the rise in operating expenses has outpaced practice revenues for the past several years while our national payment system has created a culture of "perverse incentives." "Think about hospital payments, for example," he added. "If a hospitalized patient develops complications, the Medicare DRG system actually pays the hospital more than if those complications were avoided." Similarly, in a system with a "no good deed goes unpunished" mentality, physicians who help chronically ill patients avoid hospitalizations are "rewarded" for these positive outcomes by receiving reduced income to their practice. The bottom line margin is also being eroded, Jessee noted, by rapidly rising insurance costs. With employers shifting costs to employees, hospitals and practices are seeing patients who carry more personal financial responsibility and ultimately, increases in uncollectible bad debts. "Meanwhile," he said, "health plans are reporting record profits and steadily increasing their market power through mergers and acquisitions, while steadily increasing the premiums they charge for health insurance." Jessee added that MGMA, like many other companies, had opted to become self-insured this past year when faced with a 43 percent rate hike from its former carrier. He also cited concern over the delays inherent in credentialing new physicians and consequently, the difficulty in collecting for services. "Research conducted by our Washington office earlier this year found that delays of as many as 180 days in adding a new physician to existing health plan contracts were common," he said. Jessee said other symptoms of the nation's ailing healthcare system include Medicare's inability to replenish the Trust Fund and a national desire for providers to adopt e-health enterprises with no clear strategy as to how to pay for such a massive conversion. When crafting the new strategic plan, the board of directors of MGMA and ACMPE took these environmental assumptions into account. Despite these disturbing symptoms, he pointed out that the diagnosis didn't have to be bleak. "One of the wonderful things about an association like ours is the power to create a different future," he stressed. "As individuals, each of us must inspire, act and lead," he continued. "As your association, MGMA must vault our issues to the top of the nation's priority list with visibility, strength and clarity … If we can dream it, together we can make it happen." To that end, he outlined the six key components of the new MGMA strategic plan. · Grow and diversify membership and utilize technology, service strategies and new benefits and programs to exceed member expectations and add value. · Become the nation's leading resource for professional development for medical practice executives. "We already know, from our better performing practices survey, that practices managed by ACMPE members are more financially successful than the average," he claimed. "Over the next two years, we will be conducting additional research to quantify the specific economic value that a board-certified medical practice executive or fellow can bring to the practice that employs them." · Be an important resource for information and tools to enhance patient safety, quality and satisfaction in medial group practices. Jessee said this goal is an explicit acknowledgment that these are major responsibilities for the practice manager, and not just for the clinician. He added the organization has partnered with the Institute for Healthcare Improvement on the "100,000 lives" campaign. It is collaborating with the Agency for Healthcare Research and Quality on a patient satisfaction survey in the ambulatory setting and it is developing a new patient safety assessment tool through the MGMA Center for Research. · Broaden and strengthen MGMA's market position as the leading source of useful data and information about medical group practices. The organization already offers benchmarking data to improve practice operations and is expanding its menu of specialty specific surveys such as anesthesia, cardiology and pediatrics. Jessee also said MGMA has recently created a number of free tools to help members assess electronic health records. · Be an effective policy advocate for medical group practices both in the public and private sectors. "Obviously, our number one priority in this arena is to avert the potentially disastrous cuts in Medicare physician reimbursement that are scheduled to take place over the next five years beginning in January 2006," he stressed. · Grow and expand MGMA's and ACMPE's relationships with other organizations as a means of increasing visibility and standing in the healthcare industry. "Never doubt that a group of thoughtful and committed people can change our healthcare world," Jessee concluded.