Improving Quality and Revenue in Face of Healthcare Reforms


The recent healthcare reforms proposed by the white house may affect the revenue as well as the quality of the service provided by physicians in the United States. According to a recent survey by Thomson Reuters, almost two-third of doctors in the US fear that health care reforms proposed by Mr. Obama might flood their offices which in turn would mean reduced individual attention to patients. Simply put, doctors would end up working more for lesser remuneration.

The survey also reveals that almost 68% of doctors think that the quality of service would drop because of the reforms. However, repealing the bill would also mean that more than 100 million people under the age of 65 would not be able to get health insurance because of a pre-existing condition. Nevertheless, the repeal of this bill is likely to fail in the senate. This effectively means that doctors would have to find a solution for plugging the gap between demand and supply of health care services.

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2,958 doctors were surveyed by Thomson Reuters and physician services company HCPlexus in various states and of different specialties. When asked about how they were going to handle the newly insured, more than half of them said they would have to delegate the work to an assistant or a nurse. Although this may ease the pressure on doctors, it is just a make-shift solution for a change that looms large and can take place in as less as four years.

Electronic medical records might help according to 39% of doctors who were surveyed. Moreover, delegating administrative work can also be a solution. For instance, all billing and coding can be taken care of by highly trained professionals resulting in better time management and increased revenue.

The health care reform may be a radical change but still everyone would not be covered for everything and it would still be a good practice to send electronic files to a clearing house for determining eligibility. This can save time because it would reduce the amount of claims which are denied. Providing the patients with an electronic version of the bill and E-statements instead of mailing a paper bill would further cut costs by as much as 12 to 15%.

Some resident doctors would find themselves busier than before and since Federal law does not place any limit on the working hours of residents, it would be inevitable that they would spend more and more hours treating patients who are newly insured. Although the Accreditation Council for Graduate Medical Education (ACGME) has limited the work hours of residents to 80 hours, many residents work more and report less for fear of losing accreditation. This can be advantageous for doctors who would rely on nurses, residents and assistants to catch-up with the increasing demand for health care services.

There is no quick-fix solution to this since we cannot “import” doctors from other countries and the number of doctors and nurses cannot increase to a level in such a short period of time where they would be able to meet the demands. However, since Medicare is responsible for funding a majority of residency programs, there is a possibility that the recent bottleneck in such funding can be solved in the years to come which would result in recruitment and training of new residents. Moreover, there has been a growth of around 4% in residency slots from 1998-2004 which is the result of funding from a large number of teaching hospitals.

Some branches of medicine such as radiology and internal medicine do not require long working hours and can cope with increased volume of work. However, most of the branches would struggle to cope with the increased work pressure if a pragmatic solution is not developed before the reforms take place.

The biggest advantage a doctor or a health care provider can have are good medical billers and coders who can ensure quality even when meeting deadlines. This will make the process smoother for the physician as well as relieve him or her of work pressure. For instance you can get in touch with medical billers and coders in your area and your specialty at no cost at

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