Physicians are becoming increasingly alarmed about the meteoric rise in costs to provide healthcare to their patients. Physician Practice's 2016 Great American Physician (GAP) Survey found that one-fifth of the 1,314 physician respondents say rising deductibles and cost sharing represent the largest barrier to good healthcare for their patients.
Pediatrician Terence McAllister and his spouse Leann DiDomenico McAllister, co-owner and practice administrator for their Plymouth, Mass.-based micropractice, Performance Pediatrics, say their practice and patients have been feeling the ill effects of a state decision to reel back reimbursement rates for the poorest patients.
"For patients on state assistance, the impact is in our community. Those patients are having a hard time finding any providers at all. Because even though they once had commercial primary [insurance] with the state secondary to cover their copays, now if the state is covering their deductibles, in Massachusetts the state only pays us 68 cents on the Medicare dollar [for Medicaid patients]. It is a very low amount, lower than a number of states similar in size to Massachusetts and [with] similar politics. So a lot of docs, including us, are just not taking those patients anymore," DiDomenico says.
Complicating the financial picture, third-party payers are moving en masse to insurance products with higher deductibles, placing greater financial burdens on both medical practices and their patients. What can physicians do to navigate this trend and help their patients better access care? We talked to the experts in the field to find out. Here's what they said.
*Be on the lookout for the Great American Physician Survey report, with complete results to the survey and much more. Coming soon!
BARRIERS TO PATIENT CARE
Cost has assumed a key spot in discussions revolving around healthcare reform. It is top of mind for physicians as they struggle to contend with problems created by higher patient deductibles and rising drug costs. Here are three key factors that are driving up costs:
• Payer initiatives. Travis Broome is a healthcare economist who spent the first part of his career at CMS leading the development of Meaningful Use measures. Now he is healthcare policy lead at Aledade, Inc., a Bethesda, Md.-based firm that helps small, independent practices form Accountable Care Organizations (ACOs). He says that the motivation for establishing Aledade was to give physicians the collective power to manage outside demands such as strict payer requirements, growing patient cost sharing, and government programs that aim to steer physicians toward value-based care.