Physicians enter the medical field to help people, but at the root of every interaction is a business transaction. Fiscal responsibility is an ever-present concern of any physician.
Today's American healthcare economy is unlike anything else the world has ever seen. Despite political promises to increase efficiency and reduce costs, the healthcare world has been turned upside down with continual turmoil and ever-changing policies.
The following are among the top five financial challenges facing physicians today:
- Getting Paid What They Deserve
Prior to MACRA being passed, physicians were paid based on a fee-for-service model. With the new Merit-Based Incentive Payment System (MIPS) in place, physicians must find ways to adapt their practices to ensure they receive positive scores in the categories of Quality, Resource Use, ACI, and CPIA.
- Chronic Care Management Pain Points
In theory, the Medicare Physician Fee Schedule, which governs physicians' payments for non-face-to-face care as part of chronic care management (CCM), is intended to compensate doctors for services that were previously unbillable.
Many medical facilities have discovered they were not prepared to handle the complexities associated with CCM from a documentation and billing standpoint. With strict, regimented requirements, many offices are spending excessive man hours collecting and organizing data in order to properly submit claims.
- Payer Consolidation Chaos
The payer economy already has very few players and limited competition. Recent discussions have indicated some of the country’s biggest insurers have expressed an interest in merging. With the possibility of even fewer players in the market, consumers could be facing even higher healthcare costs from a patient perspective, and providers may soon be subject to further tightening controls.
- Independent Practice vs. Employee
Despite many physicians' desires to begin or retain a private practice, the continual complexities regarding regulatory requirements, billing, and changing legislation have forced doctors to face the challenging question: Is it worth it for me to run a private practice?
- Tackling Telemed
It seems no industry can escape consumers' reliance on the mobile marketplace. As interest in remote medicine grows, physicians must develop an understanding of the billing intricacies so they can make the economics make sense for their practices.
Healthcare is constantly incurring changes and challenges. These are just five of the top situations facing physicians today. Nobody knows what problems doctors may face tomorrow until the time comes, but one thing is for certain: There's no stability in stagnation.