“It is doctors who seem to be the primary obstacle. Doctors are paid for seeing patients, not for sorting through more than 14,000 diagnostic codes and 4,500 procedure codes while a patient sits on the exam table.”
Continue reading Real Time Claim Adjudication – Universal Adoption Slow
This capability allows a provider to bill for services at the “point of service.” A fully adjudicated response is returned from Humana, detailing the total charge submitted and allowable charges, as well as the patient’s responsibility.
“The patient is not the consumer unless the patient is writing the check. Until then the patient is the cash cow, there to be milked.”
Homer T. Farnsworth, M.D.
2013 is shaping up to become the year of health care reform regulations
Doctors are most likely to reject Medicaid patients more than any health care consumer, a new survey published in Health Affairs finds.
More than three in 10 doctors—31 percent—say they wouldn’t accept new Medicaid patients.
It could spell trouble for the Patient Protection and Affordable Care Act, which aims to expand Medicaid. The number of those patients could increase by as much as 16 million due to health reform.
Less than 70 percent of doctors said they were accepting new Medicaid patients, much lower than those accepting privately insured patients (81 percent) or Medicare patients (83 patients). The reason for this is fairly obvious: Doctors get less money for treating Medicaid patients.
Sandra Decker, an economist with the Center for Disease Controls, used a survey of 4,326 office-based physicians from across the country.
The numbers did vary significantly by state. In Wyoming, for example, 99 percent of doctors were willing to accept new Medicaid patients. But only 40 percent of New Jersey doctors said they would do the same, according to the study.
October 1, 2012 • Reprints
The doctor will not be in—and it’s going to be a problem.
A new, nationwide survey of U.S. physicians shows that 34 percent say they will quit practicing medicine in the next decade, blaming health care reform and economic woes.
Their reasons for ditching medicine were split; 56 percent cited economic factors—medical malpractice and overhead costs—for retiring or leaving medicine in 2012, while 51 percent cited health reform as their reason for leaving.
[See Who’s saying what about reform?]
This year alone, 16 percent of physicians are going part-time, retiring or leaving medicine—or at least considering it, according to the survey conducted by Jackson Healthcare, one of the nation’s largest health care staffing companies.
“Physicians are retiring in large numbers just as baby boomers are starting to turn 65,” says Richard Jackson, chairman and CEO of Jackson Healthcare. “That creates a real health care access problem. Many are demoralized and weighing their options.”
Doctor associations have been quick to voice their opposition to health reform. For the most part, doctors say the PPACA will have little impact on patients’ access to medical care and only create bureaucratic hoops.
According to the Jackson Healthcare survey, specialists showing the greatest inclination to leave the profession in the next decade are: oncologists and hematologists (57 percent); ear/nose/throat specialist (49 percent); general surgeons (49 percent); cardiologists (45 percent); and urologists (42 percent).
“For doctors, there is little reward in this era of high costs, high regulation,” Jackson says. “The future of medicine is not what it used to be.”
The survey of 2,218 doctors was conducted in April, prior to the U.S. Supreme Court ruling upholding much of the Affordable Care Act.
WASHINGTON (AP) — New taxes are coming Jan. 1 to help finance President Barack Obama’s health care overhaul. Most people may not notice. But they will pay attention if Congress decides to start taxing employer-sponsored health insurance, one option in play if lawmakers can ever agree on a budget deal to reduce federal deficits.
The last thing we want to do is discourage businesses from hiring full-time workers, expanding their businesses, or undertaking complicated maneuvers to avoid fines. But as things stand, it’s looking more and more likely that the health care law would do just that.
Continue reading Hands Tied: Businesses Look For Ways Around Health Care Law
