What are Your Physicians Worrying About in the New Year?

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PHY-thumb3As healthcare executives, you interact with physicians on a daily basis, whether they’re independent of or employed by your organization. This is obvious, of course, but just how closely do you interact with them? Do you listen to them? Do you hear their views on the transformational changes occurring in healthcare right now?

In fact, according to the recently released 2014 Physicians Foundation Watch List, many of their concerns are directly related to the Affordable Care Act, reports Jacqueline Fellows of HealthLeaders Media. However, last year, most of these concerns were theoretical, since implementation had yet to begin. Now that implementation has begun and is highly problematic, these concerns have become “emergent and very real.”

For example, a major issue among physicians is the matter of uncompensated care by health insurance exchange enrollees. They have this concern for two reasons, Fellows writes: “First, reports have surfaced that 1 in 4 files with information from exchange enrollees to insurers were incomplete or wrong,” and “[s]econd, physicians have genuine reason to be concerned about the 90-day grace period that consumers have under PPACA when they don’t pay their premiums,” specifically “when an enrollee has entered into the 90-day grace period.”

According to Tom Holloway, executive vice president of the Missouri State Medical Association, CMS has only promised “guidance” on notice parameters. But, Fellows writes, “So far, the only guidance from CMS remains an April directive to insurers requiring that they notify ‘all potentially affected providers as soon as is practicable,’ though that language is not strong enough for Missouri’s provider associations or the American Medical Association.”

Quite rightfully, the provider associations say “practicable” is “an undefined standard that is subject to wide interpretation by the health plans.”

According to the Watch List, physicians are also concerned “that industry consolidation could lead to monopolization.” Fellows notes that this, too, is an offshoot of healthcare reform.

Second on the list is the burdensome regulations for physicians that only seem to grow and multiply. Physicians are expecting ICD-10 to make paperwork and compliance initiatives even more cumbersome.

Then, there’s technology. Interestingly, physicians aren’t so much worried about IT with respect to regulations, but rather with respect to “getting electronic health records to be interoperable with other providers.”

Other items on the list, Fellows writes, include “health-system stalemates…, a resolution to the Sustainable Growth Rate issue, tort reform, and the practice of defensive -medicine.”

How can you as leaders impact the profound effects that reform is having on the nation’s physicians in a positive way? How can you make them feel that they’re not in this alone and really are part of a team?

-by Pete Fernbaugh

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