Saturday, December 17, 2011

Ticket Price Increases on the Health Train Express in a Time Calling for Austerity

 

Like the airlines, who are not too big to fail, medical practices will need to find ways to increase revenues. It’s too bad our patients don’t carry  baggage  into our offices so that we could have a surcharge modifier such as –0000 for each item.

However physicians can emit a sigh of relief with the announcement from on high at HHS, as brought to us by the American Medical Association, in AMED News.  Included in that news are:

Physicians meeting criteria in 2011 to earn federal electronic medical record incentives will have more time before the Dept. of Health and Human Services requires them to satisfy tougher standards for attaining additional bonuses. The move is being viewed by physicians and health policy observers as a goodwill gesture by the Obama administration toward EMR early adopters. ( Who cares what Obama thinks about goodwill? The AMA ?)

True to form modifications are being made to the calendar for implementation-incentive reward-penalty dates because the initial proclamations and mandates were poorly planned. What we have in  the federal government is a group of “cheerleaders’ encouraging the workers how much health IT will improve patient care. Even the AMA buys into that.

No Doctor Left Behind ?  This sounds much like the Bush Plan of No child left behind.

Public health studies have shown that more doctors want to participate in the EMR adoption program. A study from the Centers for Disease Control and Prevention found 52% of office-based physicians plan to register and attest to meeting program requirements for 2011, which is an increase from the 41% who planned in 2010 to do so. The total portion of physicians who have adopted EMRs also is at 34% in 2011, up from 17% in 2008.

It takes a lawyer to make the following statement,

“There are several takeaways for physicians from Sibelius' announcement,” said Stephen Bernstein, an attorney who is the international head of the health industry practice group at McDermott Will & Emery in Boston. In general, more physicians are adopting EMRs and using the technology to improve their practices.

“HHS also is sending a message to physicians who are undecided about whether they should make a significant investment in electronic recordkeeping”, Bernstein said. “The agency will work with physicians to help them adopt EMRs”. He suggested that doctors get in touch with one of 62 federal regional extension centers that have been established to help physicians, in particular small primary care practices, adopt EMRs.

"The main message is that there are federal government programs out there to help physicians, and the federal government isn't going to stop offering help," he said.

“It’s okay, we are here from the government to help you.” (author)

Bernstein added that a robust EMR system is needed to participate in new Medicare payment models, such as accountable care organizations. If CMS wants physicians to participate in these initiatives as well, it must do everything it can to encourage doctors to use EMRs, he said.

It’s a bundled plan, just like reimbursements. Step C is dependent on steps A and B. (If they work in the first place)

Clearly it is disruption disrupting disruption. Even chaos theory fails to keep up with these advances in advanced health care physics.

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The incentive program is clearly aimed at primary care MDs, and the recent statistics reveal it.

Specialty               # Participating in   Bonus

Family practice     1,216

Internal medicine  1,198

Cardiology               517

Podiatry                   378

Gastroenterology    232

Orthopedic surgery 201

General surgery      197

Urology                    197

Nephrology              174

Neurology                148

Other                    1,347

What Medicaid Paid for EMR Bonuses

Physician               6,609             $138.5 million

Nurse practitioner  1,463               $31.1 million

Acute care hospital   607             $483.9 million

Dentist                      333                 $7.1 million

Certified nurse midwife  172             $3.7 million

Physician assistant        107             $2.3 million

Children's hospital           15           $45.1 million

What is even more worrisome is the profound recession we are experiencing, the HHS emphasizes the ARRA and Hitech have produced 50,000 job…a mere drop in the bucket. Our budget deficit is crippling planning at the federal and state level….

More than incentives we need austerity.

Stay tuned for more modifications

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