Friday, October 2, 2009
QD: News Every Day
ACP Internist's daily digest of primary care in the news continues with sudden coherence on Obamacare, prescription med fatalities and the trend of falling patient volume and procedures during the recession.
Health care reform
Overnight, Democrats and moderates in the Senate Finance Committee agreed to $400 billion in federal subsidies to defray premium costs for lower-income families and help small businesses offer coverage to their workers. Amendments will seek to let the states form their own public options and make health care affordable. But the compromise doesn't offer a permanent fix for the Sustainable Growth Rate. It could hurt physicians who are the biggest users and discourage them from taking on patients. And it still needs to merge with other bills.
If you're unclear which health care reform bill is which, the San Francisco Chronicle explains them.
In case you missed it:
Drug overdoses, mostly from prescription meds, overtook traffic accidents as the leading cause of death in some states.
The Robert Wood Johnson Foundation warns that not passing health care reform could hurt the states most of all.
Revenue in medical practices declined in 2008, possibly tied to smaller patient volumes and increasing bad debt due to patient financial hardship.
According to the "MGMA Cost Survey: 2009 Reports Based on 2008 Data," multispecialty group practices saw a 1.9% decrease in total medical revenue in 2008. (MGMA captures data on both multispecialty groups and single-specialty practices, but uses multispecialty data as a proxy for overall trends.)
Procedure volume fell 9.9% and patient volume shrunk 11.3% from 2006 to 2008. And bad debt in multispecialty group practices from fee-for-service charges increased 13% from 2006 to 2008, suggesting that patients may be having a harder time paying their medical bills.
In 2008, multispecialty practices cut overhead expenses 1.4%, largely by cutting support staff costs by 1.5%--the first decline in several years. Support staff make up 32% of medical practice expenses. While medical groups reduced support staff costs, their total worker count remained constant, indicating that employees may have gone without raises and bonuses or perhaps even suffered pay cuts.
Revenue by specialty:
Labels: drugs, health care reform, practice management, QD, recession
posted by Ryan DuBosar at
12:29 PM
0 Comments
Monday, August 24, 2009
Concierge medicine keeps traditional practices afloat
An interesting twist is happening for concierge care, the controversial practice where doctors eschew insurance reimbursement and enter into private arrangements with patients who pay a lump sum to get longer appointments, more access and often around-the-clock availability.
The practice model works for the physicians who do it, and nationally, about 800 offices have gone to concierge care, according to this profile in the Philadelphia Inquirer. The practice hasn't always earned the respect of internists, though, who say the model drives the burden of community care to doctors in the traditional model. In this twist, however, revenue from concierge arm of the practice keeps the rest of the office in the black.
Labels: practice management, primary care
posted by Ryan DuBosar at
11:59 AM
5 Comments
Wednesday, March 4, 2009
Fight back against feedback
Doctors dissatisfied with their online ratings are seeking to have them removed. One advisor suggests asking patients to sign waivers not to post reviews online.
This issue isn't new. Two years ago Texas doctors took a stand against insurers' rankings by ranking the insurers.
While it's important to protect a practice's good reputation, the best way to get a good review is to offer a good experience. If it's time to brush up on patient management skills, here's some suggested reading:
Make the wait shorter and nicer
Reduce bottlenecks
Consider ACP's Center for Practice Improvement and Innovation
Greet your patients properly
Don't be rude
Labels: patient communication, practice management
posted by Ryan DuBosar at
10:16 AM
0 Comments
Tuesday, January 13, 2009
The patient-centered medical home--at home
Sometimes medicine is cyclical. Leeches went thoroughly out of style, and then it turned out that bleeding patients really was the best treatment for conditions like hemachromatosis.
Now an internist writing in the New York Times is arguing that house calls--rather than hospitalization--are the most cost-effective and high-quality means of care for many patients. Keeping patients at home protects them from hospital-acquired infections, dementia, bedsores (not to mention simplifying discharge!), Dr. Jack Resnick says. But he has a list of complaints about how the system makes home care more difficult that it needs to be and he admits that running from door to door is tough on docs.
So is it worth it? Would you trade hospital rounds for a drive around town?
Labels: practice management
posted by Stacey Butterfield at
8:00 AM
0 Comments
Tuesday, December 23, 2008
Concierge practices reviewed as insurance
Maryland is proposing to regulate concierge medical practices as a type of insurance, prompting at least one internal medicine group to halt its plans to stop accepting private insurance, the Baltimore Sun reported.
Charter Internal Medicine of Columbia, Md., announced it will continue business as usual in a Dear Patient letter on its Web site. The group is made up of a College fellow and four members.
Concierge practitioners in other states have told ACP Internist the management method, in which doctors charge a flat fee to a limited panel in exchange for complete patient access, lets doctors practice medicine the way they see fit. But the method has even drawn fire from other doctors, who feel that limiting the number of patients harms healthcare access for the rest of the community. Maryland is the first time a state has stepped in to review the legality of concierge coverage.
Labels: practice management
posted by Ryan DuBosar at
11:11 AM
2 Comments
ACP Internist hosted Grand Rounds on June 16, wrapping up the best of the medical blogosphere. Click here for the complete wrap-up.
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