With 2018 in the record book, it's time for physicians to start looking ahead to 2019. Changes to the ways in which payers reimburse physicians for services, competition from new providers, and changes to healthcare law will all play a major role in how medical practices run their business. As the year progresses, medical practices should keep the following trends in mind so that they're prepared for the road ahead.
Healthcare Spending Will Continue to Increase
For years, spending for healthcare has been increasing at astronomical rates. Experts predict that this trend isn't stopping any time soon. In 2015, healthcare accounted for 17.8 percent of the gross domestic product; by 2025, it's expected to be 2025.
How will this affect providers in particular? It means that they might face challenges getting both patients and payers to foot the bill. While the fee-for-service reimbursement method has been viable for years, it's simply no longer feasible in this expensive world. Instead, expect insurance companies to continue to make the switch to value-based reimbursement. This ensures that patients will be receiving outcome-driven treatments based on quality rather than specific, itemized services.
MIPS and APM Will Provide Incentives
By this point in time, most physicians should be aware of the Medicare Access and CHIP Re-authorization Act of 2015 (MACRA). Two important parts of MACRA are MIPS (Merit-based Incentive Payment System) and APM (Alternative Payment Model). The initial performance period for these programs began in 2017, which means 2018 is the first year physicians will begin to benefit from these regulations.
In order to get financial incentives, physicians must comply with patient-based outcome requirements by providing electronic health records for each patient. If they do not, they will be fined between four to nine percent. The money collected from these fines will then be redistributed to the medical practices that are able to accurately track their patients' outcomes. This year alone, experts estimate that $55 billion will be redistributed among physicians.
Transformational Changes Will Be Required
Because of the changes in payer reimbursement, doctors will need to transform how their practice works in order to survive. Rather than rely on face-to-face appointments that focus on convenience for the physician rather than the patient, practices will need to be more accommodating.
This will mean having longer office hours, especially on the weekends or after standard business hours. Physicians might also need to provide open-access scheduling and more options for interaction than are currently available. This might include video chat, phone or email consultations, or even instant messaging. Otherwise, medical practices might lose business to competition that provides these services.
Patients Will Be More Open to Collaboration
As patients begin to take their health into their own hands, they'll be more open to collaborating with physicians. Nearly 25 percent of people in the United States in 2016 had some kind of wearable health device, meaning that they track their fitness, heartbeat, sleep patterns, and more on a regular basis. All of this data provides a great look into a patient's well-being when shared with a physician. In one survey of people with health insurance, 78 percent agreed that sharing their health information with providers would be useful.
Therefore, it's up to providers to make this a reality. Physicians should think about creating a new electronic system to gather and utilize this data.
Navigating your practice into the new year can be tricky, which is why M-Scribe Technologies is here to help. We are a national leader in medical claims billing and can help you ready your practice for the latest trends in medical billing. Call us now at 770-666-0470 or email us at firstname.lastname@example.org for a free analysis of your practice’s needs.