Doctors are finding themselves facing an ever-increasing array of adversities as we conclude the second decade of the 21st century. Patients and paperwork compete for their time as regulations and insurance concerns ebb and flow.
With the Affordable Care Act also under siege, practices are caught in limbo as to the ultimate outcome of that battle and what it will mean for the profession. Litigation also remains a concern, making business insurance for medical professionals an ongoing necessity.
Here are some of the other tough challenges the medical business could face in 2018.
Going to bed fatigued and waking up equally fatigued is becoming a common concern. This is largely due to the fact that doctors can no longer just be doctors. Running a medical practice has always required a degree of business acumen overlooked by medical school. But today’s challenges really push doctors beyond their comfort zones and well into both physical and emotional exhaustion.
Electronic health records have proven to be of significant benefit to the medical profession. However, they have also contributed to the depersonalization of the physician/patient relationship. Doctor visits are now conducted with a computer screen between the doctor and the patient. And, for at least half the visit, the doctor now spends more time looking at that screen than the patient’s face.
There was a time when a doctor could examine a patient, make some determinations based upon their experience and expertise and prescribe a course of treatment. Today, before they can do so they often have to check to see if an insurance provider will provide prior authorization for the proposed remedy. In many cases, this even applies to low cost routine services that have been proven effective for many years. The resulting delays can prevent patients from receiving timely treatments and make it more difficult for doctors to be paid for their services. Meanwhile, changes occur each year regarding fee-for-service and other treatment categories.
Cash flow has become considerably less predictable in the medical business than in the past. Navigating constantly changing rules regarding prior authorizations, along with dealing with factors such as EHR data entry and non-clinical paperwork have increased doctors’ non-compensated time. These factors can cost the average physician as much as $50,000 annually. Meanwhile, if insurance rules aren’t met just so, practices will find payments for service rendered refused. These factors can conspire to restrict cash flow.
Understanding Quality Measure Incentives and Disincentives
The Centers for Medicare & Medicaid Services final rule governing its Medicare Quality Payment Program changed the eligibility requirements for participation in the Merit-based Incentive Payment System. Because it’s so new and complex, medical professionals are having trouble getting their arms around it. This can make it difficult to meet the requirements needed to qualify for payment
These are but five of the tough challenges the medical business must face in 2018. Running a medical practice today is more complicated than ever before—even as an aging population and an opioid epidemic place ever-greater strains on the profession.