The AMA's latest National Economic Impact of Physicians report provides data that can be used by key health care policymakers, legislators and thought leaders. It also demonstrates how physician practices both ensure the health and well-being of communities as well as support local economies and enable jobs, growth and prosperity.
2014 was another year big year for healthcare. As we continue to move toward a more patient-centered and transparent healthcare system, so too continue the changes to our payment models, insurance coverage and commitment to patient outcome measures. While there were many changes to keep track of, three things seem to have defined the progress made in the scope of revenue cycle improvement.
There are few aspects of healthcare that are more controversial, confounding and frustrating than payment reform. It’s hard to imagine that there was ever a time when patients just paid the doctor for their services. Since that payment method created economic disparities in access among the rich and the poor, several reforms later we find ourselves somewhat on the opposite end of the spectrum: more patients than ever can have access to care, but the process for compensating physicians hasn’t been able to keep up. Doctors are rendering services without receiving payment - and their practices can’t sustain on that type of arrangement!
Value-Based Purchasing (VBP) might be the ultimate game-changer in healthcare reform. We know that our old methods of physician compensation just haven’t proven to be sustainable - and because of that, not only have healthcare finances suffered, but the quality of care has too. You’d think if we’re spending enormous amounts of our national expenditures on healthcare that it would be above-average in performance anywhere in the U.S. - but not so.
October 1st of last year, CMS cracked down on readmission rates for hospitals nationwide, handing out millions of dollars in penalties. The Affordable Care Act put these measures into place in order to curb the problem of readmissions, which are not only costly, but reflect an overall poor population health in the U.S. - especially for those patients with chronic conditions. For FY ‘14, 2% was withheld from payments per the guidelines for penalties. By 2015, the rate of withholding for penalties is expected to top 3%. In addition to the higher payments, there will also be additional diagnoses included in the readmission criteria list - it began with heart attacks, pneumonia and heart failure and will now expand to include COPD and complications from chronic lung conditions.
Research completed by Jackson Healthcare yielded an incredibly array of data on physician satisfaction. While healthcare is increasingly interested and motivated to obtain and analyze patient satisfaction, perhaps not enough attention is being paid to provider satisfaction. According to the data, which assessed not just provider disatisfaction, but also satisfaction, it might behoove the healthcare industry to keep an eye on physician happiness, too.
The subject of physician compensation is a hot one as of late. With all the changes in the financial sector of healthcare, and the push to save money, there has likewise been a focus on how- and how much- physicians are being compensated. ACOs A major change that has already begun to take place in many healthcare systems nationwide is Accountable Care Organizations (ACOs). While it’s likely too soon to know if they will work long term, in theory they will reduce the tendency of ‘silos’ in healthcare and lead to better coordination of patient care.
When it comes to the financial bottom line, medicine has evolved to be a business. While this certainly creates a host of difficulties, it also means that those who are charged with monitoring the overall financial success of an organization are privy to the use of standard business models for assessing productivity- particularly where physician productivity is concerned. Since we are moving toward value-based payment models for physician compensation, finding a way to assess and track physician’s productivity is one of the most pressing issues for healthcare organization’s in this time of great reform. However, how productivity is measured is going to vary grately depending on the size of the organization, the demographic of patients treated, and what the financial benchmarks will be during a given fiscal year.
When it comes to shifting models of physician compensation, there are many considerations ,and at times, it can be difficult to decide where your focus, as a physician or a payer, should be. As we move toward value-based payment models, we might want to consider what values already exist within our healthcare organizations that will be reflective of this shift - and by supporting them, we can lead the charge to newer payment models.
As part of BHM’s new partnership with The Doctor’s Channel, Anthony Grimaldi, BHM’s Senior Vice President Provider/Hospital Division, speaks about optimizing Pay-for-Performance models in healthcare. The Doctor’s Channel specializes in short, interesting video clips (generally 2 minutes or less) that educate doctors and other medical professionals on nearly any specialty imaginable. The vast video library also has many segments and series that are eligible for CME, making it an excellent resource for providers.