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MGMA outlines guidance for providers restoring volumes during COVID-19 pandemic

Winning back patient trust is essential to stemming the avoidance of deferred care and pumping life back into volumes.

Jeff Lagasse, Associate Editor

As the healthcare industry continues to navigate the COVID-19 pandemic, benchmarking operations through 2020 can provide a strong baseline for medical practices and their ability to survive in the coming months and along their road to recovery.

The Medical Group Management Association, in conjunction with its annual MGMA DataDive Practice Operations Report, just released "Benchmarking for Patient Access in a Post-COVID-19 World" to provide guidance and insights for medical practice administrators and physician leaders as they work their way back to pre-COVID-19 levels of appointment availability and volume  – and to have valuable data benchmarks to aspire to in this new landscape.

It's particularly timely, given that 57% of patients report having a medical condition requiring immediate attention. Winning back patient trust is essential to stemming avoidance of deferred care and restoring patient volumes. People need to feel safe when returning to their medical practice.

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The MGMA report includes fundamental metrics that dictate how medical practices can look at patient and staff experience. 

One consideration is shifting hours of operation. A typical day for medical practices for the three years before COVID-19 involved nine hours per day, Monday through Friday. Practices may now need to consider expanded hours of operations, both on weekdays and weekends, to ensure timely access to care and to stagger providers and staff in shifts to make social distancing easier to achieve.

It should be a goal to decrease patient wait times. Practices in various specialties saw increases in wait-area wait times in 2019, with primary care specialists' waiting room times jumping from 10 to 14 minutes. Many medical practices will consider shifting to new, digital check-in options in response to the pandemic and to make patients feel safe.

Leveraging patient portals is another key piece of guidance in the report. The top three reported uses of a patient portal are prescription refills, communication with providers and medical staff, and accessing test results. Practices with robust portals should enable them for any integrations with mobile device applications so appointment requests and questions for providers don't require in-person interactions.

MGMA has also promoted guidance regarding appointment availability and timeliness. Achieving timely clinic appointments helps drive growth and enhance the financial bottom line, the group said. In addition to practice closures and limited operating schedules, medical practice leaders face a big challenge in eliminating bottlenecks for bringing patients back for the care they need.

As the COVID-19 pandemic has shown, new patient volumes have suffered in 2020. To improve access and performance, practices should consider measuring the delay patients experience in accessing providers through third-next-available appointments and the use of a patient wait list to fill next-available appointments. 

Finally, given the upheaval in scheduling and patients' concerns with safety and personal finances, practices should reconsider whether to charge a no-show fee. Prior to COVID-19, fewer than 20% of single-specialty practices charged a no-show fee in 2019.

The report is based on 2019 data from more than 1,500 organizations through MGMA DataDive Practice Operations Report. More than 30,000 healthcare professionals currently utilize this data to analyze patient and medical practice trends.


Kaufman Hall data showed that July was the fifth consecutive month that had volumes falling below 2019 performance and below budget.

July volumes continued to fall year-over-year, but showed some signs of potential recovery month-over-month. Adjusted discharges were down 7% compared to July 2019, but up 6% compared to June 2020. Adjusted patient days were down 4% year-over-year, but up 7% month-over-month. Adjusted discharges are down 13%, and adjusted patient days are down 11% since the start of 2020, compared to the first seven months of 2019.

Hospital emergency department volumes have been hardest hit, falling 17% year-to-date compared to the same period in 2019, down 17% year-over-year, and 13% below budget in July. Surgery volumes saw some gains with the continued resumption of nonurgent procedures pushing operating room minutes up 3% month-over-month and 4% above budget in July, but they remain down 15% year-to-date.

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