Does Value-based Care Hurt Single Physician Practices?
By - The healthcare industry has undergone a variety of reforms in the last several years and this may be leading to workflow difficulties for physicians. From meaningful use requirements and the ICD-10 transition to the provisions of the Affordable Care Act and value-based care, physicians are spending more time working on documentation instead of direct patient care.
Today, when patients visit a doctor, they often find their physician sitting behind a computer screen and rarely making eye contact. As the amount of regulations and value-based care documentation requirements continue to rise, it is unlikely that patients will receive more careful attention from their doctors due to the ongoing data entry battles of the healthcare industry.
According to WSBT-TV, some doctors are finding that the Affordable Care Act and value-based care is causing only more difficulties among providers. Additionally, doctors have had to ensure their billing and coding systems are now up to par with the ICD-10 implementation. Along with these challenges came the meaningful use regulations, which pose technological challenges such as EHR and patient portal adoption.
“It’s been horrible,” Dr. Arnold Del Pilar, an independent family doctor, told the news source. “[It’s] too much of a financial burden, too much of a personal burden, a burden on the family, and it's just hard.”
While the goals of the Affordable Care Act, such as reducing fee-for-service programs and instituting more value-based care payment models in order to improve the quality of medical care, will likely bring a benefit to society as a whole, some of the provisions that impact individual physicians are bringing significant burdens among small medical practices.
“The overall benefit of [looking] at the system as a whole is tremendous but for an individual practitioner it can really become overwhelming,” Mark Fox, IU School of Medicine South Bend Associate Dean and Director, told the source. “Even to monitor those outcomes and performance metrics ratchets up the expectations.”
It may be that meaningful use requirements are better suited for large hospital systems instead of individual medical practices with only one or two primary doctors. Meaningful use regulations have posed a variety of new changes including EHR implementations, patient portal adoption, and electronic prescribing systems.
Additionally, the ICD-10 implementation deadline that took place on October 1 required physician practices to update all of their billing and coding systems, train their staff, and create backup strategies to ensure their reimbursement rates would remain steady.
Value-based care is also based on ensuring doctors are reimbursed not only for the quantity of work they complete but also the quality of the services they provide. As such, this raises the amount of documentation required by physicians as well.
Nonetheless, the Affordable Care Act and other healthcare reforms have brought forth better quality care and reduced medical costs. For example, Accountable Care Organizations (ACOs) are aimed at improving care coordination among multiple medical teams and lowering overall costs.
Recent studies suggest ACOs save more than $400 per patient and the pioneer ACO model saved Medicare $400 million in the past two years. Regardless of the benefits of the Affordable Care Act, many politicians are looking to repeal key provisions of the legislation, JDSupra reports.
“The House of Representatives is expected to vote on its reconciliation package the week of Oct. 19. This package would repeal provisions of the Affordable Care Act including the individual and employer mandate, the Cadillac tax (a tax on insurance plans), the medical device tax, the auto-enrollment requirement for large companies, the Prevention and Public Health Fund and IPAB, the independent advisory body that has never been staffed,” the publication reported. “In addition, the reconciliation package denies funding to Planned Parenthood for one year. It remains unclear if the Senate is going to take up this legislation. If such a package makes it to the President’s desk, it is unlikely to be signed into law.”
