5 Big Issues That Will Affect Practicing Physicians in the Near Term
The Physicians Foundation, which seeks to advance the work of practicing physicians and facilitate delivery of care to patients, takes note of five major developments that will task physicians’ ability and capacity to deliver the care for which they are trained.
The trend toward medical consolidation is increasing rapidly. Additional consolidation carries the danger of a move toward “monopolization” – eroding competition in the medical marketplace, driving more physicians out of independent practice and increasing healthcare costs due to higher payments for services performed in hospitals. While the ACA may bring new insurance options to some areas, the total number of health insurers has been decreasing for some time through consolidation – making it difficult for physicians to negotiate favorable terms.
The Foundation’s 2012 Biennial Physician Survey found that physicians are currently spending 22 percent of their time on non-clinical paperwork. Current regulatory requirements already take a substantial amount of time away from patient care, impacting both efficiency and cost-effectiveness of a physician’s practice. Add to this the looming October 2014 deadline for ICD-10 coding implementation – which will require more documentation, revised forms, re-training of staff and changes to office technology – and this percentage of time spent away from patients will likely continue to increase.
The launch of health insurance exchanges is driving high levels of confusion among patients, physicians and employers. With minimal education and support from the government, many physicians are unsure how these new insurance policies will affect their practices. Beyond technical glitches related to sign-up, there are concerns of whether reimbursement rates will be lowered, if they will be able to control the numbers of exchange-based patients added to their rolls, or if patients will suddenly “disappear” due to changes in insurance coverage.
A critical component of reform is adoption and integration of health information technology. One barrier that must be addressed is that many of these systems do not yet communicate with one another. The idea that EHRs would be shareable among physician practices, ultimately creating efficiencies and better patient care, is not happening, nor is it likely to occur in the near future. In addition, rules on how to protect the security and privacy of patient information – beyond what HIPAA has already established – have not yet been set. Providers should seek resources to understand all aspects of EHR adoption.
As physicians observe challenges facing roll-out of the ACA, as well as the drama surrounding the recent government shutdown, there is concern that important issues affecting the healthcare system are not being properly managed. These concerns include the Sustainable Growth Rate and ongoing challenges around tort reform and “defensive medicine.” As the foundation of the healthcare system, physicians require a greater sense of support and clarity from state/federal governments. Otherwise, systemic mistrust could further erode the desire of future generations to pursue medicine as a career.
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