For hospitals and physicians who want to continue to treat Medicare/Medicaid patients, there doesn’t seem to be much good news out there.  The latest news concerns the health of new Medicaid enrollees.  Americans who will enter the Medicaid program as a result of healthcare reform will be sicker than the typical program enrollee, translating into higher costs, at least initially, reports The Hill's Healthwatch.  This conclusion comes from a study commissioned by Washington, D.C. based Avalere Health, which found that two-thirds of current Medicaid enrollees report being in "excellent" or "very good" health, but that only about half of those expected to be enrolled in Medicaid starting in 2014 report that they are in "very good" or “excellent” health. This difference is explained to exist because most currently uninsured Americans do not have ready access to preventive care.

After a recent  e-survey we received many inquiries asking the definition of “enabled provider”.   By now, most of you have heard of and are somewhat familiar with Accountable Care Organizations (ACOs).  A less familiar term that is starting to be used in discussions pursuant to ACOs is Enabled Provider.  An Enabled Provider is simply a Provider (Physician and/or Facility) that is contracted with the ACO.  They are considered enabled due to the fact that they are integrated within the ACO from a contracting, systems and clinical perspective.  Please contact us with any additional ACO questions.

According to a recent NIH study, 1 in 3 Americans is dealing with some sort of pain issue, and the cost of pain in the US exceeds $550 billion dollars annually. An unbelievable twenty percent of doctor visits  entails a narcotic prescription. 

The rise in narcotic prescriptions in the US over the past decade has been exponential. When physicians write for narcotics, they are assuming substantial liability. That liability can be mitigated by a few practice safeguards. One is a pain agreement between the doctor and patient establishing the boundaries of pain medication compliance. 

As a physician, you have probably noticed that your patient load – and the accompanying revenues – tends to ebb and flow. Doctors’ incomes are not subject to the same cyclical nature as, for example, owners of retail stores, who rely on holiday shopping to make up for the slow times. However, your practice may well experience slowdowns during summer, when people take vacations, and around the holidays, when they visit family and spend all their available money and time shopping for gifts. Slowdowns do vary by specialty and geographic area; cosmetic dermatologists, for example, may see an increase in appointments as patients prepare themselves for holiday parties, and gastroenterologists may also see more patients after holiday over-indulgences.  

It appears that the legislators in Washington finally got together to pass a bill to raise the nation's debt ceiling by $2.3 trillion through 2013.  This may be good news in the short term, since the nation's credit rating will probably remain the same, at least for a while, so the interest rate the US government has to pay won't increase; but the cuts in the Federal budget tied to the increase in the debt ceiling will directly affect your practice.

Integration is all the rage within the healthcare field.  According to a new report released this week by Accenture Health, a leading management consulting firm, by the year 2013 less than a third of physicians will be in private practice, electing instead for employment with larger health systems.  Will your practice one of the few remaining, or will you combine with a hospital to form a Accountable Care Organization (ACO), aimed at reducing costs while improving the quality of healthcare.  Texas recently passed a new law allowing physicians and hospitals to integrate, where previously the law prohibited doctors and hospitals from forming monopolistic partnerships.