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Five trends to watch out for in 2012 as a result of shifting reimbursements.
In a recent article, I noted that as traditional reimbursement shifts from fee-for-service to payment based on quality of care, physicians will need to alter the way in which they practice medicine.
In that article, we covered five trends that are occurring as a result of the shift, and how physicians can begin preparing for them.
Here are the final five trends to watch in 2012 as the shift from volume to value progresses:
As federal payers seek to reduce healthcare costs while improving quality of care, they have identified care coordination and increased integration between providers as a key way to do that.
Most clearly, this is evidenced by accountable care organizations (ACOs), which call for providers to partner up to treat Medicare patients. If successful in improving care while reducing cost, ACO participants will share in a portion of the cost savings.
Of course, where federal payers lead, commercial payers tend to follow. It’s likely that physicians will encounter more and more programs which encourage them to integrate with other providers.
How to prepare? When it comes to physician/hospital integration, “selecting the right partner to affiliate with is key,” Marc Halley, president and CEO of the Halley consulting group recently told Physicians Practice. Make sure that leadership within the other healthcare system is willing to engage with you and is open to your ideas. In addition, the other healthcare system should be competitive and have a strong quality reputation.
4. Hiring competition
As hospitals seek to align with federal programs, such as ACOs, they are also seeking to acquire new physicians, especially primary-care providers. According to the Sullivan Cotter survey, 33 percent of hospitals and health systems say they increased physician staffing last year and plan to do so in 2012.
That’s partly due to the fact that new reimbursement models stress preventive care to lower healthcare costs. The thinking is that when patients receive more preventive care, costlier health problems are avoided later on.
That means that if your practice plans to hire a new physician in 2012 or 2013, competition will be fierce.
How to prepare? Vivian M. Luce, regional director of physician recruitment firm Cejka Search, recently told Physicians Practice that the time it takes to successfully recruit a physician has nearly doubled since 2002. Start your physician search earlier than usual. Here are other physician recruiting tips from Luce.
3. Hiring Opportunities
Of course, as more and more hospitals seek physicians, they will begin courting you and your practice. Perhaps they already are.
Even if hospital employment isn’t the right option for you, don’t immediately shut the recruiters down. Discuss partnership and care coordination opportunities. That way, when value-based reimbursement becomes the norm and you need to integrate with other healthcare systems, you won’t be shut out.
As other healthcare systems seek to integrate with you and your practice, keep in mind that you have bargaining power, especially when it comes to partnerships with hospitals.
Just as you will need them to improve care coordination, they also will need you. That means that you will have more leverage to ensure that arrangements are fair.
Though the shift from volume to value is stressful, it has potential.
It’s clear that traditional federal and commercial payer reimbursements are in decline, and it’s likely they aren’t going to increase anytime soon. If the payment shift toward value is successful, you may see higher reimbursements.
In addition, if you will be paid (fairly) for value of your services rather than volume, the pressure to be more productive, bill more services, perform more tests, etc., will diminish. You could in essence, be incentivized for spending good, quality time with patients.
We want to hear from you: How do you think the shift from volume to value reimbursements will affect you?