Efficiency, high quality and effectiveness are the primary goal of newly formed health care system. Earlier health care system was plague with lot of errors, incomplete coverage, expensive and no enhanced health care.

With the new reforms taking place; there's lot of confusion tagging along of whether the new bill will prove to be beneficial to the physicians of USA or not. Since, the new health care approach is to focus more on quality then quantity; physicians are unsure about their both financial and career growth.

Physicians Facing Difficult Situation In United States Today –Why?

With the new reform coming into limelight; 3rd party payment arrangements are compromising the integrity and independence of the medical profession witnesses the worst of these features.

Till this date; when a physician worked as the part of hospital owned practice, and billed Medicare he/she was paid more compared to what he/she draws for offering same services in his/her independent practice. This is because of a "good understanding" between Medicare's in-patient (Part 1) and outpatient (Part 2) medical billing schemes.

Vigorously part-taking to take benefits of these variances, hospitals have gone on a buying rampage in the recent years, buying doctor practices. One of their aims was to bring the physicians' services under the "Part 1" reimbursement scheme, where they can bill at increased rates for the same services and earn profits.

For doctors, coming under the "Part 1" medical billing scheme was a way to lock them in the long term employment agreements with the respective hospitals. It was also a way to impose the rising cost of running their outpatient medical practices onto the hospitals.

But recently, with new reform forming and putting it into the practice, said that reimbursement rates shall made site neutral. In other words, the price arbitrage between Medicare's outpatient and inpatient billing schemes should be ended.

How This New Reform Of Quality Vs Quantity Affects Physicians Of USA

The aim is to give priority to quality of health care over quantity. Medicare spending comes at a great cost to the taxpayers and at a great profit to doctors and hospitals so creating an incentive to make sure Medicare patients get proper treatment and don't end back up in hospitals is a good thing.

However; the doctors are not guaranteed to get enhanced pay check forever, but they are insured a fresh inflow of patients. This has the potential to lead to a shortage of doctors, especially in underserved and low-income communities.

Final Thoughts

Keep in mind the above mentioned, the doctors have enjoyed unrivaled job security. No physician in USA is voluntarily unemployed, and doctors who want to change employers routinely choose from several offers. Hence, the idea that doctors are suffering financially from the revolution in health care delivery, or medical billing services reform, as well as new metrics designed to reward quality of care rather than treating large volumes of patients, is a just a MYTH.

Published By - Medical Billers and Coders
Published Date - Jan-23-2017 Back

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