January 17th, 2018
Ironically, many of the top concerns facing today's healthcare practitioners have little to do with patient care. Instead, they lie on the administrative sides of operating a practice. Maintaining insurance for medical professionals, keeping up with technological advancements, and staying abreast of reimbursement changes are among the top challenges facing modern medical professionals.
Maintaining Information Technology Systems
The emergence of electronic health care record systems (EHR) has definitely improved patient care. It has also forced doctors to become more computer savvy, which means staying on top of developments in information technology. However, with threats like ransomware out there, adopting EHRs has opened small practitioners up to intrusions. This means today's medical professional must have an IT person on staff, or a consultant on call. Keeping up with software revisions and hardware changes can be a time consuming task for computer specialists, let alone physicians.
Adapting to MACRA
The Medicare Access and CHIP Reauthorization Act of 2015, revised the way physicians are paid when caring for Medicare beneficiaries. With abuses of the Medicare system coming to light, a rising chorus of voices demanded more government oversight. Under MACRA, physician pay is based on success in four performance categories. These are quality, resource use, clinical practice improvement, and advancing care information through use of health information technology. A healthcare provider's performance results are made available to Medicare beneficiaries and consumers. The goal is to help patients choose the most effective individual physicians and physician groups. However, this has added a layer of bureaucracy to running a practice and increased the administrative burden. Full implementation begins in 2018.
Negotiating With Payers
Consolidations among medical insurance providers have made negotiating with payers more difficult than in the past. With less competition among insurers, doctors are increasingly running into "take it or leave it" situations. While the prospects might seem bleak, when it comes down to it, insurers do need doctors to care for patients. With this in mind, a number of practices have begun focusing on the value they provide for insurers while negotiating.
Dealing With Prior Authorizations
A 2015 Kaiser Family Foundation analysis found 23 percent of drugs in Medicare Part D private plans required prior authorizations. This is up from eight percent in 2007. In other words, prior authorization requirements have increased steadily in recent years and the trend shows no signs of abating. Their primary function is to control costs as drugs get more expensive. But they also add another layer of red tape to the practice of medicine. With MACRA becoming the norm, there is some hope that this will dissipate somewhat. But for now, prior authorizations are a way of life.
All of these concerns are in addition to the typical challenges of managing a business. These include employee issues, equipment and supply costs, as well as insurance expenses. Happily, CoverHound can help with that last one by guiding you to the best coverage available at highly favorable rates. Best of all, we'll find you the right policy for free. Try it today!