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Editor's Blog: Doctor, this might hurt a little


Physicians are facing a cascade of change, and primary care doctors will lead them through it.


Daniel Verdon is the Group Content Director for Medical Economics, ModernMedicine.com, Managed Healthcare Executive, and Formulary magazines.


You are facing one of the greatest transitions in your professional career.

So much so, that the operational changes required due to this growing regulatory burden may be insurmountable for some practices.

As the insurance exchanges that are part of the Affordable Care Act (ACA) begin enrollment next month, remember that this is just part of a larger regulatory agenda to reduce costs, open access to healthcare, improve care delivery, and become more transparent in the way you communicate with patients and your colleagues.

As part of it, your pay will also be more closely tied to outcomes; you will be asked to open up your patient panels; and you will be incentivized or penalized by an array of government-led initiatives to re-engineer healthcare delivery.

Your medical decisions will likely be questioned in more ways than they are currently by payers, hospitals, specialists, pharmacies, your patients, and your electronic health record; and all the while, you will need to improve your systems to protect patient health information, and accommodate an entirely new segment of the population that has had little or no access to healthcare.

You will need a wealth of information to understand and respond to patient questions regarding ACA. You will likely need to fortify your business operations to manage copays as a result of high-deductible premiums. And that means you will need to keep a close eye on billing and patient charges. Who could forget the transition to ICD-10 coming up in 2014?

And while all of this is going on, you are going to have to more closely rely on your healthcare team to make certain your patients act on recommendations to reverse their poor health choices contributing to seemingly runaway health problems like obesity and diabetes.

The operational challenges are real, and, in some cases, dire for smaller practices with limited staffs and tight cash flow.

Even as physicians face this cascade of change, primary care physicians need to lead the profession through it. That is what motivated Medical Economics to take a close look at the multiple regulatory issues facing primary care this year and next (starting on page 29.) From the impacts of ACA, quality payment measures, the meaningful use 2 requirements for electronic health records, Health Insurance Portability and Accountability Act compliance, Medicaid expansion and parity, all the way to new Occupational Safety and Health Administration rules, our cover story’s goal is to inform and educate about key provisions you face in the coming months and help you plan for their implementation. While the policy pundits talk about improving healthcare delivery to patients, remember that we want you to remain just as healthy-personally and professionally.


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