Viewpoint: 4 trends to watch in 2013

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It's 2013, and the time has come to look forward to how healthcare reform will work. Here are four trends to look at throughout this year.

It’s a new year. With the election behind us, much of the uncertainty surrounding the Affordable Care Act has evaporated. Healthcare reform will proceed. So what’s new for 2013, what’s unchanged, and what does it all mean for you?

If you intend to continue treating Medicare or Medicaid patients, you’ll definitely be doing it with an electronic health record (EHR) system. If you plan to engage your practice with an accountable care organization, become a Patient-Centered Medical Home, or participate in a quality-reporting incentive program, it’s almost a sure thing you’ll need an EHR.

Either way, if you’ve held off implementing an EHR, you’d better get started. The near-stall of EHR purchasing before the election did not dampen the government’s zeal to impose digital networking on America’s healthcare system. So there’s no better time than now to start the process.

Care provision

If you support health information technology (HIT) and think that health information exchange between providers is a wonderful thing, then 2013 should be a banner year for you. If you’re not so enamored with HIT and you’re not all that concerned with health information exchange, then you have decisions to make as to how you want to attract and treat patients going forward.

You might consider becoming a direct primary care provider, accepting no Medicare. It’s a viable business model that’s coming into its own, and it doesn’t require an EHR because you won’t be accepting Medicare patients.

Unlike boutique medical practices that cater to the wealthy, the monthly subscription rates for direct primary care services in general are affordable for most patients (as low as $80 per month for unlimited primary care services). And not having to deal with insurance can be desirable for many physicians in small medical practices. It’s a way to practice medicine as it used to be done, doctor-to-patient, with no third-party involvement.

EHR adoption

The U.S. medical community hasn’t embraced EHRs as rapidly as the government might have expected it would when it began handing out incentive funds. A large percentage of America’s independent healthcare practitioners continue to object loudly to the “electronicification” of primary care. And although no working standards yet exist to support unhindered exchange of complete health records between disparate EHRs, the government soldiers on with its plan to improve outcomes while lowering costs through transferable electronic patient records.

Can it be done? We shall see. The government seems undeterred by the lackluster enthusiasm and even outright derision from doctors over the perceived usurping of what everyone assumed would always be a private industry.


Perhaps that’s for the best. Billions of taxpayer dollars already have been “invested” in modernizing our healthcare industry, and we’re nowhere near a working national model. Other industries voluntarily made the transition to network-based and Internet-based business models years ago. But not healthcare. For many reasons, the healthcare industry overall remains stalwart to its century-old communications infrastructure, tools, and methods for practicing medicine.

But the bull is out of the pen, and the herd is heading for greener pastures. If you don’t want to be left behind, it’s time to get moving.


The switch to the International Classification of Diseases, 10th Revision (ICD-10), is still happening, albeit ever so slowly. The deadline for implementation has been delayed a year, to October 1, 2014, but many outspoken voices in healthcare still argue that not enough lead time exists and that the so-called necessity to switch from the insufficient ICD-9 codes sets to ICD-10 code sets is “overrated and under-needed.”

Nevertheless, the Centers for Medicare and Medicaid Services (CMS) shows no signs of retreating from its position on the matter. CMS continues to recommend that physician practices take steps immediately to implement American National Standards Institute 5010 (the required precursor to ICD-10) and establish protocols for transitioning to the new ICD-10 codes as soon as possible.

If you are among those who have delayed purchasing an EHR, models now exist with billing systems that transfer the burden of implementing ICD-10 from you to the EHR vendors. They ensure that all of your claims are in the proper updated codes. Those systems could be your best choice at this point.

Medical apps

More than 13,000 medical apps now are available to healthcare providers for everything from prenatal monitoring to surgical decision-making. Medical apps are the foundation of a new, modern, and mobile medical workforce, one that will wield its interconnected digital healthcare tools as easily as today’s physicians handle stethoscopes and optical otoscopes.

If you’re a new care provider, or if you’re simply onboard with HIT, health information exchange, EHRs, and medical apps, than all of this technology has been on your radar for years. No new surprises for you, I’m afraid.

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