Recently I read an article in Becker’s ASC Review which helped me understand three reasons why the AMA should NOT support the healthcare plan, and a little insight as to why they do.  The three reasons why they should not:

1. On average, physicians receive 20 – 30 percent better reimbursement from commercial payors than from Medicare.  Healthcare reform will bring along with it a shift from commercial payors to Medicare. 

2.  The AMA only represents about 15 – 17 percent of the physicians in the country.  The average citizen does not understand this; they believe the AMA is THE voice of physicians. 

3.   The healthcare plan will reduce physician leverage when negotiating contracts when the primary payors will be Medicare and the public option.

You can read the article in Becker’s ASC Review by clicking here: http://tinyurl.com/ama-healthcare-support

The AMA has provided its support to the president’s healthcare reform plan with the promise from the president to provide help with Medicare reimbursement, when in actuality it will likely weaken the American health care system.  With the state Medicare is already in, it is doubtful that the president will be able to deliver to the AMA the reimbursement protections he promised.

Let us hear back from you, pro or con, on your opinion – Why is the AMA Supporting the President’s Healthcare Reform Plan?

—Marty Hudson

The Health Information Technology for Economic and Clinical Health Act (HITECH) is designed to accelerate the adoption of electronic health records and other health information technology. Physician practices, hospitals, and other health care providers are targeted to receive nearly $25 billion for the establishment of a national exchange of electronic health information. It looks like the first $5 billion will go to the National Coordinator for Health Information Technology (ONCHIT), within the Department of Health and Human Services, to set government standards and get things started. An additional $20 billion has been set aside as incentives to healthcare providers.

As incentives, the HITECH act states, in part, “…physicians will be eligible for $40,000 to $65,000 for showing that they are meaningfully using health information technology, such as through the reporting of quality measures.”

Below are the major areas as excerpted from the HITECH act:

  “This bill accomplishes four major goals that advance the use of health information technology (Health IT), such as electronic health records by:

 •Requiring the government to take a leadership role to develop standards by 2010 that allow for the nationwide electronic exchange and use of health information to improve quality and coordination of care.

 •Investing $20 billion in health information technology infrastructure and Medicare and Medicaid incentives to encourage doctors and hospitals to use HIT to electronically exchange patients’ health information.

 •Saving the government $10 billion, and generating additional savings throughout the health sector, through improvements in quality of care and care coordination, and reductions in medical errors and duplicative care.

 •Strengthening Federal privacy and security law to protect identifiable health information from misuse as the health care sector increases use of Health IT.”

Can anyone know exactly how the HITECH incentive money will be distributed?  I’m not sure, but what does seem clear to me is; healthcare organizations with existing Healthcare IT will benefit first.

What’s likely to happen?  Click here to read the rest of the article by Jerry Stone; http://www.medicalgps.com/021609-2.html

— Jerry Stone

Budget-itis:  Uncontrollable twitching and/or flinching for no apparent reason; symptoms often correlate with the turning of the leaves in autumn.

Are you in the middle of the annual budget process?  If you’re company is like most organizations in America, you’re either right in the middle of the annual budget process, or trying desperately to finish the budget process before the holidays arrive.  Having spent the best part of my 30 year career creating and/or managing to corporate budgets, it’s usually when the leaves are turning, like they have been for the last few weeks, that I start to twitch and flinch.  Maybe the memory of the long days and late-night hours are part of what causes budget-itis, but a large part of the distress results from a ludicrous budget process that embraces the misuse of comparative benchmarking data to help justify certain budget targets. 

Please allow me to explain: Have you ever been asked to perform at the 90th percentile, 75^th percentile, or sometimes just to produce above average?  Beware if the “performance” benchmark is one-dimensional, measured by one or two simple mathematical calculations such as; Support Staff FTEs per Provider, Gross or Net Dollars per Physician, LAB Tests per LAB Tech, and so on. 

The most important element in effective benchmarking is to ALWAYS include several quality measures along with the productivity measurements – what I call multi-dimensional or balanced benchmarking. Consumer feedback, clinical outcomes and productivity can be simultaneously measured and evaluated as dependent variables, all interrelated and ALL critical to contributing to the organization’s success.

As part of their annual budgeting process some service organizations resort to reducing human resources to “fix” their financial situation.  When human resources are reduced based on one-dimensional benchmarking data, the organization’s financial situation will almost always worsen. More often than not, the organization’s ability to provide the very product they are in the in business to produce – service! – is substantially diminished!  Go figure! (No pun intended).

So, if you’re starting to twitch and flinch as a result of the leaves turning you too may have budget-itis.  There’s no cure for budget-itis so far as I know, but a good dose of balanced benchmarking will keep budget-itis in check. 

 — Jerry Stone

Everything I continue to read points to the patient-provider relationship as THE key factor in determining whether or not the patient is likely to pursue litigation.   The importance of listing to, and acting on patient feedback was again made very clear to me in an article titled:

“A Friendly Approach to Reducing Medical Malpractice Litigation”, an article by Aaron A. Bucco (2006) in bepress Legal Series.

Here’s an excerpt:

“Acknowledging the physical and emotional needs of patients has the potential to effectively stop the patient from demanding, through litigation, what they are currently not receiving… attention. This is not to suggest that all medical malpractice claims arise out of a selfish desire to be noticed. Doctors do, however, have a tremendous amount to do with patient satisfaction beyond mere relief of symptoms. Attention to a patient through listening skills, compassion, and other communication techniques not only reduces the risk of patient-doctor miscommunication leading to medical error, but also relaxes the patient and allows the doctor to properly influence recovery.”

Click this link to connect to the bepress Legal Repository to download a copy of the article in its entirety: http://law.bepress.com/expresso/eps/1600.

I am convinced; listening to patients — or any consumer for that matter — and taking action based on their feedback absolutely will minimize litigation.

At the risk of sounding like a commercial promotion, (our blog is intended to inform and not to advertise), I’d be remiss not to make you aware of MedicalGPS’ M3-Patient Experience real-time patient feedback system.  The system is so affordable; it eliminates the affordability argument. 

— Jerry Stone