From the debates in Town Halls to so-called political “tea parties” we seem to be witnessing an unprecedented level of anger and hostility in this country. Since a lot of this anger seems to be fueled by the state of healthcare, what is the practitioner to do when this aggression trickles into the office and effects relationships with staff and patients alike?
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It seems like an image from a Norman Rockwell painting of a bygone era – the physician, black bag in hand, stethoscope around his neck, plodding through the snow to make a house call. Nostalgia aside, house calls are making a comeback, thanks largely to Electronic Medical Records, (EMRs) and other digital “mobile medical” technology.
This return to the past not only represents improved patient care – it makes pragmatic business sense. Insurance companies embrace the idea of house calls because they realize that paying for a doctor to see a sedentary or shut in patient who cannot otherwise get out to see a physician, can prevent a more costly hospital admission for that patient down the line.
Physicians agree that they get a clearer picture of patients who are suffering from a “lifestyle issue” – such as obesity or diabetes – when they can see them in their own environment. Portable medical records, and other digital diagnostic devices such as glucose monitors, EKGs and laptop-based tests-make such visits as productive as those in the office.
The elderly are especially benefiting from this “Back to The Future Approach” to medicine. According to the Journal of the American Medical Association, house calls to Medicare recipients have risen by over 40% since 2004.
The shift represents a “new” business model for physicians struggling to keep their practices viable in these tough economic times. Hospitals are developing such House Call initiatives and encourage local doctors to participate, as are independent businesses. One such company is Chicago’s Mobile Doctors. For the past 10 years, the company has been showing doctors how to add valueand revenue to their practices by joining the Mobile Doctor network.
Recent studies suggest that physicians can create a profitable practice by eliminating the overhead associated with the office-based medicine, and focusing entirely on house calls.
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In August the Department of Health and Human Services (HHS) proposed new regulations for defining and reporting security breaches of patient information under the Health Insurance Portability and Accountability Act (HIPAA). The new regulations are specifically tied to requirements in the section of the Stimulus Bill known as the HITECH Act, that provide for the adoption of Electronic Health Records (EHRs). The new HIPAA regulations went into effect on September 23rd.
Under new regulations, if patient information is stolen, or otherwise compromised, practices must notify the affected patients and, in some cases, th U.S. Department of Health and Human Services and the local media. The regulations are tied to the extent of the breach, with different notification requirements if the problem involves more than, or less than 500 patients.
So what does all of this mean to your practice?
“This will be a tremendous burden to small practices,” says attorney Ed Gaines, chief compliance officer of Medical Management Professionals, Inc. in Greensboro, North Carolina. “The individual medical practices are going to have to be very careful in understanding and analyzing who has what on their computers.”
As part of the new regulations, practices that can prove that they have proper security measures in place, that prevent breaches by using a number of specified ways, including encryption and destruction techniques -are exempt from the regulations. So if you are not currently using an EHR solution that provides such protection of your patient’s data, now is a good time to start thinking about implementing one.
While the new rules took effect in September, enforcement won’t begin until February 22, 2010. The complete text and more information about the regulations can be found at: http://www.hhs.gov/ocr/privacy/
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Any doctor who doesn’t believe that they will be taking the hit to finance healthcare reform (an every other government run program) is in la la land. Check out what just happened in Michigan.
“The Democratic-led House approved the 3 percent tax on physicians’ gross receipts earlier in the month to prevent cuts in government-funded health care for the poor and disabled. But it died in the GOP-run Senate on a 32-4 vote, with Democrats complaining they were given no chance to suggest improvements to the House bill.” (Mlive.com)
It passed in the Democratic led House of Representatives and died in the Republican led Senate. Take a look at your State and Federal legislatures and figure out what the chances are that doctors will be financing any new government health program.
Let us know your thoughts.
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After the President’s speech on September 9th, J. James Rohack, MD, President of the AMA released a statement that read in part, “President Obama recognized what physicians have long known – that medical liability reform is needed to bring down the cost of health care, and he is directing the Department of Health and Human Services to take action now. Recognizing the critical need for medical liability reform is an important step toward reducing unnecessary costs. Everyday physicians across the country are forced to consider the broken medical liability system when making decisions, resulting in defensive medicine that adds to unnecessary health costs. We cannot ignore this problem if health-system reform is going to address the growing cost of care.” The AMA sent a letter to the President urging him that any agreement on healthcare must include such medical liability reform
No matter what shape healthcare reform eventually takes, one thing seems certain – the next “healthcare crisis” will be lack of access to doctors. Consider these distressing facts:
In 2008 a survey conducted by the Physicians Foundation found that of 270,000 primary care physicians currently in practice – 54% of them said they plan on retiring or seeing fewer patients within the next 5-10 years. More than 60% said they would not, or have not, recommended medicine as a career for their children. This has already created a shortfall of about 50,000 primary care physicians, which the survey estimates could grow to over 200,000 by 2019. The survey also found that 36% of doctors were disaffected with Primary Care Practice due to low Medicare reimbursements.
“Universal Coverage” is a great idea – but what good is having medical insurance if you can’t find a doctor? Massachusetts is ground zero for “Mandatory Universal Healthcare”. Currently less than 3% of Massachusetts’s residents are without health insurance – yet waiting time to see a doctor in five different specialties is over 50 days!
Most doctors cite yearly decreases in Medicare reimbursements and rising medical malpractice rates – as the most common reason for early retirement. Any healthcare reform bill that does not address these issues will do little to increase Americans access to quality doctors – whether they have coverage or not.
ShareHas anyone figured out how to make cash medicine strategies work in a medical practice? If you have, tell us what you’ve done that’s worked.
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