Physicians are routinely surveyed on many topics, but practice costs could be among the most important as they will impact the calculation for reimbursement rates, according to an article in Health Affairs.
Here are five things to know:
1. The recorded practice expense represents 41 percent of Medicare's calculation for reimbursement while malpractice expenses make up 5 percent. However, since the calculation went into effect in 1992, there has been a decrease in data collection efforts.
2. The need to track practice costs is acute, especially with the changes in healthcare. For example, the American Medical Association reported the transition to ICD-10 could cost large practices $2 million to $8 million in a 2014 study. A separate report showed the cost and productivity loss could account for more than $15 billion annually to report quality measures.
At the same time, the last time the Medicare Payment Advisory Commission sponsored a survey on physician practice costs was in 2008.
3. The Physicians Foundation conducted physician surveys in 2008, 2012 and 2014 but had a 3.1 percent response rate. "The survey, however, is useful for generating hypotheses and may also be helpful in tracking trends since a reasonable assumption is that the direction of any response error is likely to be similar in direction and magnitude over time," Marc L. Berk, contributing editor at Health Affairs, wrote in the article.
The Agency for Healthcare Research and Quality is also working toward reporting more on physician practice expenses with the Medical Organization Survey, currently in field testing. The survey would include the Medical Expenditure Panel Survey with a medical provider component that would ask respondents to validate expenditure data.
However, the surveys don't necessarily report on practice costs.
4. Developing physician surveys is difficult and can be expensive. There will be "considerable effort" necessary to collect practice cost data with a special eye for how response bias could negatively affect the efforts, as it has in the past. The article author suggested CMS consider a "more minimalist approach" to the survey that would focus on fewer practice cost components and ideally illicit more response.
5. Mr. Berk recommended the practice cost survey be attached to an ongoing federal survey such as the MEPS provider component or NAMCS so that there would be higher response rates with less data collected. Both federal surveys have high response rates; the NAMCS had 59.7 percent response rate in 2012.