The 5 top stories of the year in practice management

Male doctor in white lab coat
News from salary hikes to healthcare fraud is of interest to practice leaders. (Getty/Saklakova)

There’s certain news that’s almost guaranteed to get practice management readers interested.

So we decided to take a step back and look at some of the top stories of the year that got practice management leaders reading. Take a look below.

1. Salaries

Medicine Money
(Getty/utah778)

Ok, everyone wants to know what the other guy or gal makes. And, of course, if they themselves are making enough in comparison.

Among the big stats this year: Medical specialists are in increasing demand, and their salaries reflect that fact, according to a new report. A mid-year report by Merritt Hawkins found specialists continued to dominate the list of leading salaries. Invasive cardiologists have the highest average starting salary at $648,000, compared to family medicine physicians who earn an average of $239,000.

RELATED: Specialist physicians in high demand, and their salaries reflect it 

A Doximity report released this month showed a mismatch, however, between the highest-paid specialties and the most in-demand specialties. Primary care physicians are the most in-demand, but among the lowest paid, according to the study.

But the report showed indications that the healthcare industry may be starting to up the salaries for some specialties that are in short supply. When looking at the growth in compensation by specialty, the study found that pediatrics experienced the highest pay increase in 2019. Pediatricians saw a 9% increase in salaries, followed by preventive medicine with an 8% increase. 

It’s not just physician salaries that readers are interested in. A report from the Medical Group Management Association found that medical practice leaders saw sizable compensation increases over the last year.

2. Medicare for All, shifting politics

Physicians and practice leaders are following the “Medicare for All” debate. And while most doctors once opposed a single-payer healthcare system, one poll showed a shift in thought among many. In a poll of healthcare workers, almost half of physicians said they support "Medicare for All." The poll found 49% of doctors support the proposal to replace private health insurance with a new, federally financed healthcare system.

That may be an indication of the shifting, left-leaning political affiliation among physicians in recent years.

For instance, while it continues to oppose “Medicare for All,” the American Medical Association (AMA) dropped out of a coalition organized to fight the healthcare proposal. The AMA decided to leave the Partnership for America’s Health Care Future, an industry group that opposes Medicare for All but said that does not signal a policy change on the part of the AMA, which will continue to oppose a single-payer system.

The AMA’s annual meeting in June opened with a demonstration by doctors, nurses, medical students and community activists criticizing the association’s position and urging them to support expanding Medicare to cover all Americans. Members voted to adopt a new policy that boosts its push for universal coverage by improving the Affordable Care Act. The delegates also defeated a motion to remove the AMA’s opposition to a single-payer approach to health system reform. However, that vote was reportedly a close one that divided the membership, with 53% voting to maintain opposition.

The debate will no doubt continue as some Democratic presidential candidates have made Medicare for All a key campaign issue.

3. The fallout from the opioid crisis

Doctors welcomed clarification from the Centers for Disease Control and Prevention (CDC) of its controversial federal guideline for prescribing opioids, which it issued three years ago in the face of the opioid epidemic sweeping the country.

The guidelines had left many physicians struggling with how to best treat patients’ pain while cutting back on the use of opioids. The CDC said the guidelines were not intended to deny chronic pain patients relief from opioids and encouraged physicians to use their “clinical judgment” in prescribing the medications, which can be addictive.

RELATED: CDC clarifies opioid prescribing guideline, says doctors should use their 'clinical judgment'

Physicians were also aware of the federal crackdown on opioid prescribing. One of the largest opioid busts occurred as dozens of medical professionals in Appalachia, a region hard-hit by the U.S. opioid crisis, were charged in April with writing hundreds of thousands of illegal prescriptions and committing healthcare fraud.

Addiction
(Getty/BackyardProduction)

Following undercover investigations by an opioid strike force, the government has charged 60 people in five states, including 53 medical professionals, with illegally prescribing opioids and other narcotics, some in exchange for cash and sex.

RELATED: Doctors in 5 states charged with illegally prescribing opioids, some in exchange for cash, sex

In a second crackdown in Appalachia, 11 physicians were charged with illegally dispensing opioids through so-called “pill mills”. And in Texas, 16 medical professionals, including six doctors and seven pharmacists, were among those charged in September in a healthcare fraud and opioid takedown.

4. The nitty-gritty of operating a practice

Physician practice leaders are also busy with the nitty-gritty of operating a practice and keeping track of all the changes that impact them.  While they may sound mundane to outsiders, practice leaders care about the details.

Changes, such as updates to the Current Procedural Terminology (CPT) codes for 2020, including new codes to keep doctors up-to-date with new technology, will impact practices.

The CPT codes, which describe medical, surgical and diagnostic services provided to patients, are used to bill outpatient and office procedures. Among the changes for 2020 are codes that will give doctors more room to bill for e-visits and remote patient monitoring.

RELATED: CPT changes in 2020 include new codes to allow doctors to bill for digital health 

And they care about the change that’s coming for advanced diagnostic imaging services furnished in a physician’s office, hospital outpatient department or ambulatory surgery center.

Starting Jan. 1, the Centers for Medicare & Medicaid Services (CMS) will implement new appropriate use criteria (AUC) that will require ordering professionals to consult a qualified Clinical Decision Support Mechanism (CDSM) prior to ordering Medicare Part B advanced diagnostic imaging services for a patient that will take place in those settings.

RELATED: CMS to implement new appropriate use criteria for advanced diagnostic imaging in 2020 

5.Healthcare fraud

Fraud is at the root of some of the most shocking news stories.

There’s no shortage of physicians and other healthcare leaders who get in trouble every year. In the largest healthcare fraud case the Department of Justice said it has ever prosecuted, a Florida executive was sentenced to 20 years in prison.

Philip Esformes, who was convicted in April for his role in a $1.3 billion scheme to defraud Medicare and Medicaid, was sentenced to jail.

Gavel money handcuffs fraud
(Getty Images/alfexe)

Esformes, 50, a wealthy Miami businessman who operated a network of nursing homes and assisted living facilities in South Florida, wept in court as he delivered a 16-minute speech apologizing for his actions and asking for mercy.

And a Tennessee state senator and two other physicians who owned a now-closed pain clinic company were charged with defrauding Medicare and Medicaid of more than $25 million.

In other cases, 14 doctors and other medical professionals were among those charged in fraud schemes that totaled $258 million in California, Oregon and Arizona.

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