Primary Care Physicians Take Note Of Reform Possibilities

Physicians seem to be most concerned about the managed care aspects of healthcare reform around the board. With the shift to a marketplace of more insureds (either by workplace mandates or Medicaid eligibility expansion) and the rise in risk-based compensation, there is a concern that panic is on the horizon. Physicians, especially primary care physicians, need to be more cautious and look for the silver lining in any situation. For more details click Partida Corona Medical Center.

To begin with, the sky is not falling. It’s shifting, as it always is, but it’s not going to collapse. It is axiomatic to believe that health-care reform is unavoidable. It is, of course. It is, however, naive to believe that one can predict exactly what it would entail. That said, if the healthcare reform laws are any indication of what’s to come, the insured (government or commercial) sector will exhibit the following characteristics in the future:

  1. A move away from fee-for-service billing over time;
  2. And incorporation of information technology (e.g., EMR) into healthcare; 3. Increased outcome-based assessment and payment linkage; and 4. Healthcare businesses and medical practises merging in different ways.

“We’ve been here before,” some experts have said. Remember when capitation, IPA, and PHO were all the rage in the 1990s? True, but there was never any talk of linking reimbursement to any kind of quality metrics back then. They are, however, in agreement on the need to improve compensation methodologies that accomplish three goals:

  1. Increase the number of people covered by insurance;
  2. 2. Slow the pace of increase in healthcare costs; and
  3. 3. Track quality.

While concerns about the approaches proposed to achieve those three goals are understandable, and while physicians must examine how they do business (in the insured marketplace) and consider alternatives (e.g., IPAs, practise mergers), there has been little discussion of the more proprietary opportunities offered to physicians in the face of change.