With the increasing popularity of Accountable Care Organizations (ACOs), the quest for affordable care may not seem too far. Health IT has helped transform the care structure, enabling physicians to become more responsive to change. Today, almost 55% of physicians have access to electronic medical records (EMRs) helping engage other concerned parties across the care continuum. However, the support for this change is not free of personal concerns.
The healthcare reform focuses on two key elements, quality and affordability of care. While most professionals will resonate with these principles, there is some uneasiness regarding the course laid out by the government. “While the consequences may be unintended, the current healthcare reform clearly favors hospital based physicians over private practices. It is increasingly becoming difficult for solo practitioners to work independently. Reimbursements are low, costs are high and then there is the regulatory pressure.” says a Practice Manager in New Jersey.
The last few years have also shown a trend amongst large healthcare corporations of acquiring smaller independent practices. Competition is rife, and while independent physicians struggle to keep up with business expenditure, hospitals and health corps are moving on to electronic platforms with EMRs and independent health information exchanges (HIEs). “It is creating a technological gap. Solo practitioners are still struggling with EMR adoption while hospitals have started to receive their return on investments.” says one industry expert.
A significant percentile of physicians reports a decrease in overall revenue with the economic depression. Revenue cycles are drawn out with claim complexities further jeopardizing business health for solo providers. “ACOs are being slated as the next generation of healthcare organizations. Practices that fail to embrace the concept and the technology will soon become dinosaurs.” says a Hospital Administrator.
The fee-for-performance does not appease every provider. With the level of competition in the medical services market, solo providers have much to lose already. Most physicians are advocating a blended system including fee for service along with an outcome based reimbursement. George Kamajian, DO from Florida complains that the government policies do not involve the physicians in such (reimbursement) decisions. Kamajian believes that this is in fact the main reason why most patients requiring care are deprived of it, “It all comes down to government guidelines and barriers and restrictions.”