The Plight of the Small Doc
I recently called my doctor to schedule a check-up and learned he had dropped my insurer. Said payor shall remain nameless, but my small group practice doctor had had enough battling to get paid in a timely fashion. When the job of getting paid is tougher than the practice of providing care, you know something is broken in the business of healthcare.
While the WebMDs, Cerners and Intels of the world are grabbing headlines and joining hands in a healthcare interoperability kumbayah, the majority of doctors in the United States are being left out in the cold. These are the doctors of small and medium-sized practices that comprise 70% of healthcare delivery and who most need technology. Ironically they are also the group least able to afford EMR or PPM technology.
My doctor had a rudimentary EMR that didn't address the reimbursement cycle management that is the financial lifeblood of any practice. This is the boat the majority of small and medium sized practices are in. Hundreds of payors offer thousands of benefit packages, each a little different from the other. Medical practices can't keep pace. The result: claims denied or delayed up to 70-90 days, a payment cycle that would put most companies out of business.
Sure EMR increases doctor efficiency and streamlines workflow, but a truly useful EMR solution gets docs out of the reimbursement management morass with automated coding and payor interaction.
We've all heard solutions to tackle this problem. I agree with what my now-former doctor said: neither the vendors nor government alone can fix healthcare, it will take combined public and private efforts. A few weeks ago at HIMSS, Rep. Phil Gingrey, M.D., (R-GA) recommended tax incentives to encourage EMR adoption. His proposal calls for increased deductions for healthcare organizations that purchase IT. Financial incentives must be in place to motivate the purchase, then the technology must truly yield ROI to maintain its use.
Tags: Cerner, EMR, healthcare, healthcare+interoperability, PPM, WebMDPosted by Shawn Whalen on April 3, 2006 at 9:21 PM
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