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GOP Proposes New ACA Reforms


In its latest attempt to unravel the ACA, Republicans unveil a proposal to transfer federal healthcare spending into state block grants.

Welcome to Practice Rounds, our weekly column exploring what's being covered in the larger world of healthcare.

GOP Proposes Massive Block Grants

On Wednesday four GOP senators unveiled a plan to transfer federal healthcare spending into state block grants. The Graham-Cassidy-Heller-Johnson bill, named for co-sponsors Sens. Lindsey Graham (R-S.C.), Bill Cassidy (R-La.), Dean Heller (R-Nev.), and Ron Johnson (R-Wis.), would turn the billions spent on the ACA's Medicaid expansion, tax credits, and subsidies into grants managed by each state.

The bill would leave in place most of the financial props that support the ACA, while doing away with a tax on medical devices. The bill allows each state to define its own rules for health plans that may be sold to residents and the help consumers should receive to afford that insurance, according to The Washington Post.

While maintaining the ACA's taxes, the proposal would repeal many of Obamacare's laws disliked by Republicans, including the requirements that most Americans carry insurance and that large employers offer health coverage. The proposed bill would start in 2020.

Study: Docs Spend Six Hours a Day with EHR

A recent study published in the Annals of Family Medicine concluded that primary -care physicians spend nearly two hours on EHR tasks per hour of direct patient care. This equates to spending six hours of their 11.4 hour work day in front of the computer.

The study was done using 142 family medicine physicians using the same Epic EHR system. EHR interactions were captured from event logging records over a three-year period for both direct patient care and non–face-to-face activities.

Of the six hours a day, 86 minutes came after clinic hours were over for the day, while 4.5 hours came during clinic hours, according to the study. As for what physicians are doing during this time, administrative tasks such as documentation, order entry, and billing accounted for nearly one-half of their time, with inbox management  accounted for a quarter of the time.

Telemedicine Saving Time and Money

Patients who use telemedicine for sports medicine appointments are saving time and money, according to a study by Nemours Children's Health System.

The study found that on average, patients saved $50 in travel costs and 51 minutes in waiting room time by using telemedicine. Furthermore, patients also saved the health system an average of $24 while spending more time with their healthcare provider (88 percent vs. 15 percent).

The study's researchers used 120 patients under 18 years old, each of whom had at least one telemedicine visit from September 2015 to August 2016. Researchers compared the total time of the telemedicine visit, percentage of time spent with the physician, and wait time, to data from the patients' in-person visits.

Following each telemedicine visit, parents were asked to complete a five-question survey on satisfaction. More than 90 percent of parents found the telemedicine application easy to download, 98 percent reported they would be interested in future telemedicine visits, and 99 percent said they would recommend telemedicine to other families.

Quote of the week:

So You Want to be a Part-Time Physician?

"Find a small office space, hire a few people, buy your equipment as inexpensive as possible, let people know that you're there, and establish rapport with your patients…..Yes, there are startup costs, but it's not bad. If you were in practice even for a short period of time [before DPC], your patients can find you and your practice can grow."

- Napoleon Maminta, DO on starting a DPC practice. 

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