Newsmaker Interview: William Jessee

By Bernie Monegain
12:00 AM

What is MGMA’s greatest challenge for the year ahead?

A permanent fix to the broken Medicare SGR payment formula, and the related lowered payments from private payers.

We’d prefer to see broader reform in the healthcare payment system so that physicians are truly rewarded economically for preventing illness, providing safe, high quality care, practicing efficiently, etc., but we think that is not likely to happen in the short term.  So we’re focused on fixing the SGR formula as “plan B.” We think that is a difficult, but achievable goal.


What was MGMA’s greatest achievement this year?

Clearly, preventing a 10.6 percent cut in Medicare physician payment rates on July 1 has to rank at the top. We believe that our members’ incredible grassroots response to our call for letters and e-mails to their House and Senate representatives was a major factor in that victory.

But we’re also excited about our victory in achieving a change in the “deeming” provisions in Medicare Advantage plans to make it more difficult for these plans to avoid the necessity of disclosing contract terms to practices and negotiating network agreements with them.

We also see our launch of our new social networking software – a first among healthcare associations – as a major innovation in our effort to create value for our members from their MGMA membership.


What excites you most about the 2008 annual conference?

The new format, with an opening session on Sunday afternoon, and windup at noon Saturday makes it easier for our members – esp. those from the East Coast – to participate. I’m also excited by the outstanding lineup of plenary session speakers, and the chock full menu of breakout sessions.

We’ll have a very “green” meeting this year, with paper minimized and other steps to conserve energy and limited resources.

Our general session on the “state of U.S. healthcare” and the impact of the upcoming elections promises to be most stimulating along with our unveiling of our positions on many of the healthcare reform proposals of the two presidential candidates.

Finally, we hope to launch a major administrative simplification initiative at the Annual Conference.

What on the information technology front surprised you the most this year?

The extremely slow progress on EHR adoption among physician groups, and the continued unwillingness of the administration and Congress to recognize that they are going to have to provide economic incentives if they truly want an e-health revolution to occur. It just isn’t happening on its own.


What do you say to proponents of ICD-10 who say a 2011 deadline for conversion works?  

I’d say they either are unfamiliar with ICD-10-CM and its 170,000 codes, or they are completely out of touch with medical practices and their billing processes.

ICD-10-CM is a great system for collecting epidemiologic data, so long as you can get people to collect the level of detail in medical records that is required by the coding system.

But it is designed to produce better public health and vital statistics info – not to be used in billing. Its rapid implementation will literally paralyze the healthcare insurance payment system. It will make HIPAA implementation look like a cakewalk.

What are you reading?

Just finished a book on the “secret” voyage of Sir Francis Drake to the Northwest coast of North America in 1577-79.

It was secret in that Queen Elizabeth I suppressed publication of the specifics of his voyage for fear that the Spanish might follow after him in his quest for the elusive Northwest Passage, which prevailing wisdom held was real (before global warming...), and which the English wanted to protect as their exclusive secret.