The 60 year effort to put in universal health coverage in the
First: this is not socialized medicine, nor is it government run healthcare, so let’s go off these lies.
The goal is to cover all Americans for healthcare. Most likely, there will be a basic, mandated level of services, and employers and individuals will be able to purchase richer coverage. There may be some tax on employer benefits at some level as a partial means of paying for the currently uninsured.
Healthcare is messy – often chaotic, unplanned and reactive more than planned and scheduled, stressful – in short, if it was that easy, anyone could do it. So restructuring efforts are going to be, well, messy. And different, and G-d knows people don’t cope well with change.
The Senate Finance Committee recently issued a description of policy options, and this frames out much of where we will probably end up. It’s worth a read to gain a sense of the issues and thinking behind them.
Within your practice, here are the key issues to focus on:
1. Quality: yes, it’s a bit fuzzy what is meant here, but it’s commonly accepted that all healthcare services are not necessary in that the findings will not make any difference in the clinical decision making nor add useful information. It’s not so much about cutting costs as getting value for the $2.4 trillion we spend on healthcare. That’s the rub – too much is unnecessary, and fraud is still significant (some say 3%, some say more).
You: Take a hard look at what you do. Look at imaging orders in particular, as these are the higher cost.
2. Primary care will be getting more dollars and more training slots. Specialists will slowly get less. Imaging services are a likely target for fee cuts.
3. Electronic records are coming – for real. Adopting EHR is very messy, so start planning and preparing for a transition. A key success factor: you need to change some of the ways you practice to use the tool for your benefit. IT is fundamental to being more efficient in the long run.
4. Universal, mandatory coverage will increase demand for your services as more patients will be able to pay for care.
You can make as much or more money even if your price is cut. To do so, of course, you have to become more efficient in how you are organized and operate. Practices should be planning for and investing in technology to run faster and more efficiently in the back office, freeing time for physicians and patients.
Stay tuned – and get busy.