The Centers for Medicare & Medicaid Services (CMS) is conducting another ICD-10 readiness assessment, according to a notice posted in the Aug. 10 Federal Register. Selected participants have until Oct. 9 to comment. (more…)
September 10th, 2012
An IMS Institute for Healthcare Informatics survey released April 4 shows a drop in physician office visits and prescription use. As patients struggle with high deductibles, co-pays, and general economic issues they are more likely to ask their physician about cheaper alternatives for tests and prescriptions, or to find other alternatives rather than seeing their doctor.
IMS’ report findings are similar to reports from the Kaiser Family Foundation and Chase health industry analyst John Rex. Their reports also found a decline in office visits. Another survey report, released November 2011 by Commonwealth Fund, said 42 percent of “sicker” adults had more cost-related access problems than in the previous year.
IMS’ report found that from 2010 to 2011:
- Retail pharmacy prescription spending declined 1.1 percent.
- Prescription spending by insured patients ages 19-25 went up 2 percent.
- Patients 65 and older spent 3.1 percent less out-of-pocket for prescriptions.
- Ages 65-69 had the biggest prescription decline, with a 4.3 percent drop.
- The biggest prescription decline was for those treating hypertension.
- Non-emergency hospital admissions declined 0.1 percent.
- Emergency admissions went up 7.4 percent.
The increase in emergency admissions is an indicator that patients are reluctant to seek medical treatment from their physician office or to take medications because of financial concerns. Larry Levitt, senior vice president of the Kaiser Family Foundation said, “It suggests people are putting off care, and they’re showing up sicker.”
According to the survey, here are the statistics showing the number of office visit changes from prior years:
2002 – 1,503,225,000: 2.7%
2003 – 1,589,694,000: 5.8%
2004 – 1,565,978,000: -1.5%
2005 – 1,654,375,000: 5.6%
2006 – 1,670,502,000: 1.0%
2007 – 1,624,189,000: -2.8%
2008 – 1,627,786,000: 0.2%
2009 – 1,602,354,000: -1.6%
2010 – 1,535,506,000: -4.2%
2011 – 1,468,265,000: -4.7%
Advice for Physicians Who are Seeing a Decline
According to an amednews.com article, here’s what physicians can do to make it more likely that financially strapped patients will follow advice for prevention and treatment:
- Explain the value of the recommended medication, test, or procedure even if the patient doesn’t ask. Barry Make, MD, a pulmonologist with National Jewish Health in Denver, said, “Patients will only do something if they understand what it is for, but patients are often reluctant or ashamed or embarrassed to ask.”
- Make it clear that some negotiation is possible if cost is a significant concern. For example, see a patient every four months rather than every three.
- Steer patients to lower-cost prescription resources and write prescriptions for drugs to be filled cheaper at big pharmacies.
- Guide patients to drug assistance programs or discount programs.
Source: IMS Institute for Healthcare Informatics “The Use of Medicines in the United States: Review of 2011“
April 27th, 2012
The results of the sixth annual Medicare Contractor Provider Satisfaction Survey (MCPSS) indicate an overall satisfaction level providers have with their Medicare contractors’ performance, with nearly 73 percent stating they are either satisfied (54.48 percent) or very satisfied (18.02 percent). The survey, conducted by the Centers for Medicare & Medicaid Services (CMS), had a good response rate, as well. Out of the 30,000 Medicare fee-for-service (FFS) providers and suppliers across the country who were asked to participate in the survey, over 16,000 responded.
September 16th, 2011
A recent survey by Accenture concludes that physicians are increasingly moving away from private practice, choosing instead to sell their practices to, or work directly for, health care systems. “Some are doing so to gain stability in an uncertain business environment or reduce their administrative responsibilities; others, to gain improved access to health care IT tools, facilities or equipment; still others, to gain a more manageable workweek,” the survey overview states. “Hospitals, for their part, are aggressively acquiring physicians to lock in physicians and secure patient volumes.”
Accenture conducted in-person and phone interviews with hospital executives and industry stakeholders September to November last year, and completed its analysis in 2011. The survey predicts that by 2013, less than one-third of physicians in the United States will remain in private practice “and patients may increasingly find that being treated by physicians in private, small practice settings may be a thing of the past.”
The survey concludes with the recommendation that physicians and groups address four key points regarding health care integration:
- Health care IT, medical device, and pharmaceutical companies will need to understand the implications of proliferation of hospital-owned medical groups for their customer segmentation, go-to-market and distribution strategies.
- The payer sector will need to understand how to manage its client relationships and physician networks. As physicians increasingly associate with larger groups and health systems, payers will have to determine what integrated physician-hospital organizations’ greater negotiating leverage will mean for payers’ business strategies.
- Hospitals will want to determine how to recruit and retain enough physicians with the right skills to capitalize on high-growth-potential service lines such as cardiovascular care, orthopedics, cancer care, and radiology.
- Physicians must ask what alignment model will best allow them to manage the trade-offs between autonomy and employment.
July 1st, 2011
The same research that indicates payers are coming right along in their ICD-10 implementation plans also reveals an uncertainty on behalf of payers that the provider community is just as on top of things. Will providers make the Oct. 1, 2013 deadline for ICD-10 conversion? Of the 100 health care payers The TriZetto Group, Inc., in partnership with The Gantry Group, surveyed earlier this year, 86 percent of them said that provider-readiness was their biggest concern.
June 10th, 2011