Dwight Mankin on Healthcare Payment Reform

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Doctors concerned about effects of healthcare reform

female doc with colleagues iStock 000008112869Small resized 600

In a recent survey conducted by Thomson Reuters/HCPlexus, physicians were asked a series of questions relating to health reform and the future of healthcare. Of the 3,000 physicians surveyed, 65% worried that healthcare reform would produce lower pay and lower quality of care.  As the old saying goes, be careful for what you wish for.  During the debate the AMA came out in support of the health reform bill.  I realize the AMA does not have the strong voice with providers as they did in the past but they still carry weight in their support or lack of support of health issues. 

As reported by Bernie Monegain the key findings of the survey showed the following:

  • During the next five years, 18 percent say the quality of healthcare in this country will improve, 17 percent say it will stay the same and 65 percent say it will deteriorate.
  • 9 percent of the doctors surveyed say The Affordable Care Act will result in physician reimbursement becoming fairer, while 17 percent say it will neither be fair nor unfair and 74 percent believe it will be less fair.
  • 27 percent of physicians believe the impact of the Affordable Care Act for patients will be positive, 15 percent say it will be neutral and 57 percent say it will be negative.
  • 8 percent of physicians believe the impact of the Affordable Care Act on them will be positive, while 14 percent say it will be neutral and 78 percent say it will be negative.

We are now entering the next round of debates with the House voting to repeal the bill and waiting to see what the Senate will do; the next few days will be interesting.  We all know that repealing the ACA will not be possible.  What is clear, based on this survey, is that physicians are realizing the next few years will be a defining moment.  Things have to change.  They must change.  We must provide a rational system where providers, payers and consumers are all sitting at the table and developing solutions that will balance the competing interests of the marketplace.  If we don’t, I would hate to see if the survey is conducted two years from now what the results will look like.

Source:

2011 National Physicians Survey polled 2,958 physicians of varying specialties and practice types in all states. Thomson Reuters and HCPLexus conducted the survey in September 2010 and updated it in December 2010 and January.

Happy New Year – The New Reality of Healthcare

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As we start the New Year we are faced with the reality that healthcare rates continue to rise and the employers who just received their renewal rates for health premiums are increasing their deductibles and coinsurance for their employees.  Gone are the days when employees had a $100 to $200 deductible with coinsurance ranging from $750 to $1,500.  Today individual deductibles are at $500 to $1,000 (and even higher) with coinsurance at the $3,000 to $10,000 range.  This is the new reality. 

With this new reality, patients are going to have to be fully engaged in the pricing discussion with their provider.  No longer is the discussion centered on should a certain treatment or medication be received.  It now includes “what are you going to charge me for this service?” and “can I afford this treatment?”

Just walking in a plopping down an insurance ID card with a simple $10 copay for office visit has gone the way of Leisure Suits and 8-track tape players. 

In the January 8th, edition of the New York Times there is an interesting article on how to negotiate with a provider for care.  We will be seeing more of these articles in the coming months and employers will need to start arming their employees with tools and solutions to help them navigate the new reality.  We offer such tools through our ConsumerScope web tool and iPhone application, and many more tools will be implemented in the coming months.

This country's current system of every provider being in a Preferred Provider Network (PPO) while rate increases keep going up by 20-40% per year is not sustainable.  The “New Reality” is here.  New solutions and ideas will need to be implemented or the system that will likely occur is one few will enjoy. Have you negotiated for care?

 

A Talk With the Doctor May Help Patients Afford Care:
http://www.nytimes.com/2011/01/08/health/policy/08patient.html?_r=1&scp=1&sq=A%20Talk%20With%20the%20Doctor%20May%20Help%20Patients%20Afford%20Care&st=cse

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