August 6th, 2012
As the U.S. healthcare system moves into a new era, the question of transparency is likely to become an increasingly important issue for providers and health plans. Under the Affordable Care Act (ACA), patients will have greater access to insurance plans and more coverage options to consider. But to make well-informed decisions, patients will need to be able to access information relating to cost, price and quality, such as:
How much will choosing a higher deductible reduce my premiums?
How much is my co-pay or my out-of-pocket cost for various procedures or treatments?
How large is the plan’s network of providers?
What is the quality of care delivered by a provider (and how is quality measured)?
What is the average cost of a certain procedure or treatment in my area?
Is plan A or plan B a better choice for me and my family?
These types of questions will become even more important when state health exchanges become operational in 2014. Both the exchanges and employer-sponsored plans will include cost-sharing provisions. That’s a positive step for the overall system, since patients today usually have little knowledge about the cost of services they are purchasing from their providers. In fact, the key financial figures – provider’s cost, insurance reimbursement and patient’s out-of-pocket payments – bear little relation to each other in the minds of most patients.
In addition, patients have little opportunity to compare the cost and the quality of care offered by different providers in their communities. Instead, patients choose physicians and hospitals based on factors like personal recommendations, convenience and provider websites. Hopefully, implementation of the ACA will eventually bring more transparency to the complicated issues of cost and quality of U.S. healthcare.
July 23rd, 2012
A recent announcement from Health and Human Services (HHS) Secretary Kathleen Sebelius points to the growing importance of Accountable Care Organizations (ACOs) in serving the nation’s Medicare patients. As of July 1, more than 2.4 million beneficiaries were receiving care from providers participating in ACOs, which are formed by groups of doctors and other healthcare providers to deliver coordinated patient care.
Noting the recent formation of 89 new ACOs, Sebelius said almost half are physician-driven organizations serving fewer than 10,000 beneficiaries. These ACOs have entered into agreements with Centers for Medicare & Medicaid (CMS) that provide an opportunity to share in savings realized through high-quality, coordinated care. “We applaud every one of these doctors, hospitals, health centers and others for working together,” said Sebelius.
While participation in an ACO is purely voluntary for providers, it’s clear that the federal government has a strong stake in this program, which was made possible by the 2010 Affordable Care Act. One reason: federal savings from this initiative could be up to $940 million over four years.
There could also be significant potential financial benefits for participating physician groups who join with other providers to form an ACO that meets the federal criteria. For example, CMS has established 33 quality measures for 2012 relating to care coordination and patient safety, appropriate use of preventive health services, improved care for at-risk populations, and patient and caregiver experience of care.
However, U.S. healthcare providers will need to weigh the potential financial benefit with the actual costs related to forming an ACO - including preparing a mutually acceptable agreement, completing an application and meeting CMS quality standards - before making a decision to take part in this initiative.
July 2nd, 2012
With the U.S. Supreme Court’s historic June 28 decision upholding the 2010 Affordable Care Act (ACA), healthcare organizations across the country can expect to see an increase in patient volume over the next few years. Now, hospitals, physicians and other providers have clear guidance from Washington to guide their strategic planning for the next few years. While it’s possible that the act could be repealed by a Republican-controlled Congress after the November election, healthcare organizations should ramp up their preparations for the law’s impact.
Certainly, the ACA will make it easier for millions of Americans to access the healthcare system. It requires individuals to have health insurance – the so-called individual mandate – either through an employer or a state-sponsored exchange. It also prevents insurers from denying coverage to people with pre-existing medical conditions, and requires them to cover preventative care without additional costs.
So, the big question is what will happen when all those newly insured Americans arrive at a hospital, clinic or physician office. Will there be enough physicians, PAs, nurses and other professionals to provide quality care? How can healthcare organizations minimize waiting times and provide cost-effective diagnostic and treatment services?
To cope with the increased demand, healthcare providers will need to review their staffing arrangements and operational procedures. That could mean expanding the facility to include more examination rooms, or it might mean extending office hours to accommodate more patients in the existing space. Providers should also consider their staffing options, including temporary, part-time or full-time employees. As the healthcare landscape evolves, All Medical Personnel’s staffing services can provide a valuable resource in this strategic planning process.
May 21st, 2012
Throughout the country, healthcare organizations are turning to locum tenens physicians to meet their patient care requirements. A recent report from Staffing Industry Analysts, forecasts the market for temporary physician staffing will increase about 7 percent this year and reach the $2.1 billion level. All Medical Personnel’s dedicated locum tenens staffing team has seen a comparable increase in assignments during the first four months of 2012.
There are several forces driving the increased demand for locum tenens physicians, including a shortage of full-time medical professionals in a growing number of locations around the nation. While physician assistants, nurses and other “physician extenders” can pick up some of the burden of care, an M.D. or D.O. is still needed to supervise their work, diagnose complex conditions and prescribe the most appropriate treatment.
In 2012, the demand for locum tenens physicians would likely be even higher, if the U.S. economy were in a full-scale recovery mode. That’s because many potential patients, concerned about costs, are postponing doctor visits and elective surgery. In some cases they are also waiting for the Affordable Care Act’s access- and insurance-related provisions to kick in, although the U.S. Supreme Court is now considering the constitutional issues related to that 2010 act.
For clinics, community hospitals, and regional healthcare systems, locum tenens staffing provides a flexible approach to physician coverage. For instance, primary care physicians and specialists can be hired to meet a seasonal peak in demand during the summer months or used as “fill ins” for doctors who are taking their own vacations. In any case, locum tenens staffing is expected to play a growing role in patient care for at least the remainder of the decade.