To borrow the words of Lou Goodman, president of the nonprofit Physicians Foundation, "2013 will be a watershed year for the U.S. healthcare system." For physician practices, the upcoming New Year will be a pivotal one, in many cases, making the difference between folding and thriving in a post-health-reform world.
Here, in no particular order, are 10 existing trends we predict will affect your practice in 2013 and beyond.
Most of the United States is in the middle of a difficult transition from still-dominant fee-for-service reimbursement to a variety of emerging value-based payment models. With a cost-containment law passed in 2012, Massachusetts continues to be a state to watch as you evaluate options for your own practice going forward. In addition, the American Medical Association has released a how-to manual to help physicians understand and negotiate new payment models.
Alternative care models
According to a report from Accenture, only 36 percent of physicians in the United States will practice independently in 2013. Of this remaining minority, one in three is expected to resort to subscription-based models, such as concierge, direct-pay or online consultations, to sustain profits. Whether these models represent your future or your competition, keep a close eye on such businesses to emulate their strengths and learn from their mistakes.
This trend has become so prevalent that the American Medical Association released a set of guidelines designed to protect patient care and physician interests in various employment arrangements. FiercePracticeManagement also spoke to top experts about how physicians can negotiate employment contracts, something they're not typically trained to do. Our sources told us that they would like to see contract negotiation included in medical school curriculum, but for the time being, physicians can look to medical societies and trade publications for help.
Conflicts of interest
Regardless of when the Centers for Medicare & Medicaid Services begins collecting data related to the Sunshine Act, media reports describing physician ties to pharmaceutical and other industries has drawn patients' attention to potential physician biases and conflicts of interest. And as physicians and patients increasingly interact online, doctors are left to figure out the best way to disclose any conflicts when using social media--a tricky thing to do in 140 characters or fewer.
Poorly managed stress not only hinders physicians' performance, possibly leading to burnout, but it can also be deadly. With physician shortages predicted to explode, it's paramount to help keep our doctors healthy and happy. Too often, physician wellness programs are designed to assist physicians only after they've developed a substance abuse problem or been accused of inappropriate behavior. Just like you emphasize with your patients, it's time to take a proactive approach to physician health.
In the ACA era, physicians will be substantially more accountable to ensure their patients take their medications, get recommended tests and generally become more responsible for their health. A strict paternalistic approach won't motivate patient behavior. Physicians must further hone their communication skills and explore other ways to educate and engage patients.
If it feels like you're being asked to do more work for patients with less time and the same or less compensation, you probably are--and will continue to do so. In 2013 and beyond, efficiency will be much more than a buzzword; it will mean survival. Be proactive in finding ways to streamline your practice operations and the way you deliver care without compromising quality.
Patients' financial responsibility
There is growing momentum toward the idea that physicians and health organizations need to be more upfront and willing to discuss patients' personal cost of their care. But disclosing and considering costs for patients' sake is only half of the equation. As Brandon Betancourt, business director of Salud Pediatrics, told listeners of yesterday's Fierce webinar on fixing revenue leaks, practices have a responsibility to their patients to ensure they collect all the revenue to which they are entitled. By creating a culture in which patient balances are collected consistently, the practice then has the revenue to hire the best doctors, purchase the best equipment and deliver the best care, he said. "A broke doctor doesn't do anybody any good."
Not all doctors--and fewer by the day--prescribe narcotics to treat pain. But the problem of prescription painkiller addiction has become so huge that it will continue to affect the medical field as a whole. States have been experimenting with various solutions from drug-tracking databases to random drug testing of patients. Whatever your specialty, have a voice in addressing this problem, and listen intently to your patients.
All things HIT
Advances in electronic health records, mobile health and health IT evolve so fast that it's hard to keep up. Fortunately, you have access to three Fierce publications dedicated solely to bringing you the latest news on all three fronts. If you don't subscribe already, be sure to check out FierceHealthIT, FierceEMR and FierceMobileHealthcare.
We wish you a very happy and Fierce holiday season and look forward to greeting you again on January 2, 2013! - Deb (@PracticeMgt)