According to the Association of American Medical Colleges report, in 2013 there were about 767,000 doctors practicing in the United States. However, the report continues to claim that the U.S. will face a shortage of as many as 90,000 physicians by 2025. The problem is that although the supply of doctors will grow, it will not grow nearly as quickly as the demand for care. This will be a known obstacle for the future, but what about current challenges?
For National Doctor’s Day, let’s take a minute to acknowledge and bring awareness to the challenges physicians are currently facing or will be battling in 2015.
- Complying with ICD-10 code sets. The ICD-9 code sets will be replaced by ICD-10 in October of this year, which means healthcare providers, payers, clearinghouses and billing services must prepare for the transition. According to the Centers for Medicare and Medicaid Services (CMS), ICD-10 will affect diagnosis and inpatient procedure coding for everyone covered by the Health Insurance Portability and Accountability Act (HIPAA), not just those who submit Medicare or Medicaid claims. Facilities will need to redo their back end systems and reprogram their software in order to bill properly with ICD-10, which is where the challenges will lie.
- Implementing EHR. “In order to meet new Medicare guidelines and not be punished financially on the back end, physicians must introduce Electronic Health Record (EHR) software into their offices,” says Scott Wakser, vice president of sales, Medline. This requires a large capital outlay for implementation, support and maintenance, and a significant amount of training time. For smaller practices that do not have an IT person, they will have to weigh in additional costs for IT outsourcing to support their EHRs.
- Moving away from “fee-for-service.” Old practice encouraged fee-for-service; a method where providers are paid for each service performed. Now, for 2015, physicians must learn to make the shift toward a method that rewards quality and outcomes; a method that looks at several aspects of care and the service provided, which will pose challenges. To push for a fee-for-performance method focusing on quality, it was announced that there would be financial drawbacks for not reporting Physician Quality Reporting System (PQRS) data to CMS. For example, according to a Medical Economics write-up, in the beginning of 2015, practices that did not report PQRS data in 2013 were docked 1.5% in their Medicare reimbursements. That amount will rise to 2 percent in 2016.
- Remaining independent. Practices are expanding and hospitals are beginning to take ownership of physician practices for clinical integration. The challenge for many physicians is staying or returning to independent practice. In the Medical Economics article, OmniMD Chief Executive Officer Divan Dave said some physicians are returning to private practice because their compensation from hospitals became less attractive after the expiration of their initial contract. With the shift toward fee-for-performance, physicians may see a change in their pay once a contract is up.
This list only touches the tip of the iceberg when it comes to the many challenges physicians face. For National Doctor’s Day, let’s celebrate the hard work of our healthcare professionals in navigating and working to resolve 21st century, industry challenges and creating a better, more advanced healthcare system.
What challenges do you see physicians face?
Bernstein, L. (n.d.). U.S. faces 90,000 doctor shortage by 2025, medical school association warns. http://www.washingtonpost.com/news/to-your-health/wp/2015/03/03/u-s-faces-90000-doctor-shortage-by-2025-medical-school-association-warns/ Accessed March 25, 2015
Centers for Medicare and Medicaid Services. ICD 10. (n.d.). http://www.cms.gov/Medicare/Coding/ICD10/index.html?redirect=/icd10 Accessed March 25, 2015
Centers for Medicare and Medicaid Services. The ICD-10 Transition (pdf). (n.d.). http://www.cms.gov/Medicare/Coding/ICD10/Downloads/ICD10Introduction20140819.pdf Accessed March 25, 2015
Terry, K., Ritchie, A., Marbury, D., Smith, L., & Pofeldt, E. (n.d.). Top 15 challenges facing physicians in 2015. http://medicaleconomics.modernmedicine.com/medical-economics/news/top-15-challenges-facing-physicians-2015?page=full Accessed March 25, 2015