Practice Management

Have you and your colleagues expended significant time and money to understand and meet the requirements of a law that may be declared unconstitutional? The answer is not clear at this point, but at least the issue is headed toward resolution. The U.S. Supreme Court has agreed to rule on the constitutionality of the Patient Protection and Affordable Care Act, with oral arguments likely this spring and a decision later next year. Find out what issues before the court could have the biggest effect on your practice.

The American Medical Association House of Delegates has voted to “work vigorously to stop implementation of ICD-10” by an October 2013 deadline. But don’t get your hopes up. The smart money is probably on the government. Find out what the Centers for Medicare and Medicaid Services said about changing the deadline, and why the agency is so anxious to start using the new coding system.

A new government initiative will begin awarding $1 billion in funds next March to physician offices and other healthcare sites exploring creative ways to deliver high-quality medical care and reduce costs for people enrolled in Medicare, Medicaid, and the Children’s Health Insurance Program. Projects that can be up and running in 6 months or less and demonstrate a model for sustainability after the 3-year award period will have priority. Find out why it might be worth a look to see if your practice can qualify.

Here’s a novel use of electronic health records: Using the technology to provide an “electronic cohort” that allows you to evaluate a course of treatment on a real-time basis. Usually, physicians rely on randomized, controlled trials, when possible, and turn to expert opinion when necessary. But what if experts aren't available or testing is inconclusive? Find out how a medical team used a quick analysis of an EHR database to determine treatment of a pediatric patient with systemic lupus erythematosus complicated by nephritic-range proteinuria, antiphospholipid antibodies, and pancreatitis.

Responding to a new report that says growing pains for health information technology are creating some short-term safety issues, technology experts say physicians should remember one immutable fact: The new systems are far less dangerous than the old paper-based systems still used by many practices. The Institute of Medicine said there have been reported cases of patient injury related to medication dosing errors, failure to detect fatal illnesses, and treatment delays due to poor human-computer interactions or loss of data. Read on to learn how can you avoid these errors when using technology in your practice.

A liberal advocacy group says that liability reform in Texas shouldn’t be a model for the rest of the nation because the only beneficiaries are doctors and malpractice insurance companies. It also maintains that healthcare is scarcer in the state and more expensive than the national average-claims disputed by supporters. You might be interested in what the report says about the drops in the frequency and dollar amounts of liability payments since malpractice caps were instituted.

Here’s something you may not want to hear as you scramble to meet the October 1, 2013, deadline for ICD-10 conversion: ICD-11 will be available about 2 years later. That reality was discussed at the recent American Health Information Management Association meeting, which featured a speaker from the World Health Organization, the developer of the International Classification of Diseases. Find out why the next conversion might not be as burdensome.

Nearly half of physician practices do not meet national standards to qualify quality as a Patient-Centered Medical Home, with smaller, single-specialty groups being the least likely to qualify, according to a new study. Ninety percent of Americans receive care from those smaller practices, however. Learn how solo and single-specialty practices can even the playing field to meet medical home standards.

The government is jumping the gun in trying to develop metadata standards for healthcare technology, according to two industry groups. Those standards are proposed for meaningful use stage 2 and could affect your electronic health record implementation. Find out what prompted concerns that standards are too early for metadata, which embed descriptive information about the meaning and use of data.

Making sure all of your older patients receive necessary vaccines is a challenge; 34% of adults aged more than 65 years fail to get a seasonal influenza vaccine and 40% lack pneumococcal vaccinations. Your electronic medical record system could provide an effective solution, however. A recent study reports that EMR reminders increase pneumococcal vaccination rates by 50% and raise influenza vaccination rates 20%, compared with usual care. How can this system work for you, and how much of your time will it require?

Will this year’s A-Rod be wearing a white coat and stethoscope? Although no one is offering a $275 million contract, doctors just entering the field have become a hot commodity. A recent survey found that more than 75% of physicians in their final year of training received at least 50 job solicitations, and half got 100 or more. If you think, however, that being in demand makes newly minted physicians happy with their chosen profession, think again.

Proponents of lower payments for primary care providers argue that work requiring less mental challenge and stress should pay less. The problem with that “relative value” position is that, according to a recent study, overall work intensity actually is quite similar across medical specialties. Find out why researchers believe the instruments currently used to measure physician work intensity are flawed.

Here’s a straightforward way for Congress' Joint Select Committee on Deficit Reduction to save $62.4 billion over 10 years without cutting payments to healthcare providers: Institute meaningful medical liability reform. That was what the American Medical Association, the American Academy of Family Physicians, the American College of Physicians and more than 90 other state and specialty medical societies told the so-called “supercommittee.” Read on to see the specific recommendations.

Who are you going to hire to help implement and maintain your increasingly sophisticated electronic health record systems over the next few years? Depending on where you live, that could be a real challenge, according to the American Health Information Management Association. The group warns that, in many parts of the country, no one will be available without concerted training and incentives. Find out what's being done to increase the supply of trained professionals for practices such as yours.

The Medicare Payment Advisory Commission will officially recommend to Congress a plan that repeals the sustainable growth rate formula and replaces it with a mechanism to keep rates steady for primary care physicians over the next decade while cutting payments to specialists. Not surprisingly, the AMA and specialty societies strongly oppose the plan. Find out why the AAFP also has concerns.

The Centers for Medicare and Medicaid Services has finalized the rules for the federal e-prescribing incentive program.

Managing your online presence involves more than just creating a Web site.

Claims and suits against physician assistants and their supervising physicians are rare, and the outcomes are usually favorable for the defense.

Learn how to deal with aggressive salespeople.

Find out whether patient surveys are worth the time and expense.

October 1, 2013, the way you code your claims will change from ICD-9 to ICD-10.

Federal healthcare fraud prosecutions are on pace to increase by 85% over last year due to a new emphasis on enforcement.

The author discusses a moving realization she experienced related to those who are unemployed with no health insurance during her attendance at an annual AAFP meeting.

Learn the ins and outs of billing in a concierge practice.

Hospitals are hiring more doctors to try and gain market share through referral bases and admissions, according to a new study.