{"id":6966,"date":"2013-05-21T08:00:00","date_gmt":"2013-05-21T12:00:00","guid":{"rendered":"http:\/\/www.poweryourpractice.com\/?p=6966"},"modified":"2025-06-30T11:19:50","modified_gmt":"2025-06-30T11:19:50","slug":"3-government-mandates-hurting-practice-profitability","status":"publish","type":"post","link":"https:\/\/carecloud.com\/continuum\/3-government-mandates-hurting-practice-profitability\/","title":{"rendered":"3 Government Mandates Hurting Practice Profitability"},"content":{"rendered":"

According to a new study from CareCloud and QuantiaMD, a variety of issues are resulting in a downward trend in practice profitability. Among the four most commonly-cited obstacles, three are related to government regulations and mandates.<\/p>\n

The survey, a partnership between cloud-based health technology provider,\u00a0CareCloud<\/a>, and\u00a0QuantiaMD, the largest online physician\u2019s community, was created to provide a voice to practices across the U.S. regarding issues that impact their financial and operational health.<\/p>\n

<\/p>\n

Out of the more than 5,012 physicians surveyed, 48% consider the Affordable Care Act to be the primary government-driven initiative negatively affecting their profitability in 2013. The looming ICD-10 switch comes in a close second at 44%; followed by the government\u2019s EHR adoption push at 26%.<\/p>\n

Affordable Care Act<\/strong>
\n<\/strong>We\u2019ve all heard the arguments\u00a0for<\/a>\u00a0and\u00a0against<\/a>\u00a0President Obama\u2019s Affordable Care Act. Yet, the prevalent consensus among physicians points to a decline in doctor reimbursements in long run.<\/p>\n

As a result of Obamacare\u2019s individual insurance mandate, the\u00a0Medicaid program is estimated to grow by at least 16 million applicants<\/strong>\u00a0in the coming years. Because Medicaid reimbursement rates are lower than those of private insurance, many doctors are dreading the\u00a0influx of new public patients<\/a>.<\/p>\n

Doctors currently earn $20 for each Medicaid patient, versus $260 per privately insured visit. Oftentimes private practices actually\u00a0lose\u00a0<\/em>money on Medicaid patients due to operating costs. This issue hasn\u2019t been adequately addressed by the ACA.<\/p>\n

Another ACA provision, the expanded use of bundled payments, is also troubling many physicians.\u00a0 Bundling is supposed to coordinate care by aligning payments across providers for services delivered through an entire episode of care, such as heart bypass or hip replacements, rather than paying for each service separately.<\/p>\n

Many doctors, though, are predicting that bundling may hinder care.<\/p>\n

“It may not cover the more expensive regimens,\u201d said Dr. Justin Favaro, an oncologist from the Oncologist Specialists of Charlotte.<\/p>\n

\u201cEvery time a patient comes through the door, we treat them the way they should be treated. We choose the regimen that is best for them. That may be the… least expensive regimen or most expensive regimen. It really depends on the patient, what their health problems are. We don’t want to be restricted,” he added.<\/p>\n

ICD-10<\/strong>
\n<\/strong>Let\u2019s face it. Many physicians are freaking out over the impending ICD-10 deadline coming October 1, 2014.<\/p>\n

Not only is it set to dramatically complicate coding procedures for your staff, if not implemented correctly, but ICD-10 could also cost you big bucks.<\/p>\n

Learning to utilize<\/a>\u00a0the roughly 150,000 codes under ICD-10, instead of the 18,000 currently in ICD-9, is estimated to take billers and coders between 50 to 100 hours each. The hundreds of hours your staffers and doctors will spend in training are time they won\u2019t spend performing their usual duties —\u00a0consequently slowing down productivity.<\/strong><\/p>\n

\u201cICD-10 demands significantly more specificity in\u00a0diagnosing and coding<\/a>, something the healthcare landscape isn\u2019t accustomed to or skilled in effecting at this time,\u201d said Alex Johnson, HIT Consultant and founder of\u00a0CredentialedCare.<\/p>\n

Although the expansion of medical codes is supposed to encourage improved, more detailed reimbursements,\u00a0expect a decrease in collections<\/strong>\u00a0until your practice learns how to correctly bill with the new coding system.<\/p>\n

\u201cIn the short-run, ICD-10 could be highly disruptive to reimbursement patterns.\u00a0 However, in the long run, the coding specificity will enable the public health system to target health promotion strategies in a more effective way and we predict that claims data will be more meaningful,\u201d added Johnson.<\/p>\n

The EHR Adoption Push<\/strong>
\n<\/strong>For the past few years, CMS has been trying to encourage national EHR adoption by promoting its\u00a0EHR Incentive Programs.<\/p>\n

Through these initiatives, eligible professionals can receive tens of thousands of dollars for demonstrating Meaningful Use of certified EHR technology. However, its been shown the\u00a0government\u2019s incentive amount does not cover the entirety of costs associated with implementing a new EHR.<\/strong><\/p>\n

A new system can cost thousands of dollars to purchase, not including the cost of new equipment and training required to properly operate new software.<\/p>\n

Cloud-based EHRs\u00a0can provide a relatively inexpensive alternative to client-server EHR systems since there\u2019s no need to purchase hardware. But it will not reduce the time needed to transfer patient records from paper charts to electronic formats.<\/p>\n

With these government programs in mind, it\u2019s no surprise 57% of physicians surveyed in the QuantiaMD study cited rising costs as a major financial challenge for 2013. Between the hiring of new staff, retraining of existing employees, and purchasing of new equipment to meet technological needs, practices are scrambling to keep up with new legislation.<\/p>\n","protected":false},"excerpt":{"rendered":"

According to a new study from CareCloud and QuantiaMD, a variety of issues are resulting in a downward trend in practice profitability. Among the four most commonly-cited obstacles, three are related to government regulations and mandates. The survey, a partnership between cloud-based health technology provider,\u00a0CareCloud, and\u00a0QuantiaMD, the largest online physician\u2019s community, was created to provide […]<\/p>\n","protected":false},"author":1,"featured_media":32787,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4],"tags":[38,39],"class_list":["post-6966","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-revenue","tag-icd-10","tag-revenue"],"yoast_head":"\n3 Lies Your EHR Wants You to Believe \u2013 CareCloud<\/title>\n<meta name=\"description\" content=\"According to a new survey, physicians cite government intervention as the definitive issue hurting practice profitability in 2013.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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