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Practice management knowledge hub

Is your practice running as efficiently as possible? Discover tips and insights that can help streamline your practice management.

Managing healthcare reform

Healthcare reform

Of the sizable challenges your practice will face over the next five to ten years, managing healthcare reform is perhaps the greatest. The major healthcare reforms currently in sight include Meaningful Use, ICD-10 and the various levels of payment reform. The combined effect will be a continual need for practices to adapt, procedurally and technically, to demands that can make managing healthcare reform time-consuming and expensive – so time-consuming and expensive, in fact, that some practices may face the possibility of going out of business.

Many practices have already been through the process of Meaningful Use Stage 1 attestation. Practices with EHR vendors that were equipped to handle the data gathering and submission requirements for attestation experienced less disruption than others; but they still had to alter practice procedures and adapt technology to meet Meaningful Use Stage 1 demands.

Meaningful Use Stage 2 will demand even more change management. While Stage 1 required providers to meet 10 out of a combined 13 core objectives plus five menu measures, Stage 2 increases that requirement to 17 core objectives plus three out of six menu items. Although this is a basic summary, it’s clear that the demands made on practices to meet these Stage 2 requirements can be significant.

Simultaneous with Meaningful Use Stage 2 in 2014, another healthcare reform initiative will be ramping up for an October 2014 ICD-10 deadline. Dealing with roughly five times the number of ambulatory diagnosis codes will put a significant strain on a practice’s providers and coders, and there is no guarantee that payers will be ready to handle the new codes, even if practices are ready. Without significant assistance from an EHR vendor, this transition could cause chaos in the medical office.

Finally, when it comes to managing healthcare reform, coping with payment reform may be the most complex challenge of all. It could take a decade or more for an entire shift away from the fee-for-service payment structure, but the industry has reached a point where payment reform should be regarded as inevitable. No one knows, however, exactly how payment reform will evolve over time, and which programs will succeed and which will fail. Regardless the change will involve significant adjustments in medical billing procedures and in how practices predict their revenue stream.

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