Top doc concerns in 2013: ACA implementation, loss of autonomy

With 30 million new patients expected to enter the healthcare system, doctors worry there won't be enough of them to go around.
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"2013 will be a watershed year for the U.S. healthcare system," Lou Goodman, president of the nonprofit Physicians Foundation, said in a statement about the Foundation's new Physicians Watch List for 2013.

This list, based on a series of research reports from the foundation, identifies the top five issues concerning physicians in the new year, many of which we have and will continue to follow closely at FiercePracticeManagement:

  • Health reform implementation
    The Supreme Court ruling to uphold the Affordable Care Act, coupled with the re-election of President Barack Obama means that health reform is here to stay. Of particular concern to doctors as 2012 draws to a close is the Medicare physician fee schedule, with an impending 27 percent cut set to start in the new year, and the controversial independent payment advisory board, Healthcare Finance News reported.
     
  • Consolidation
    Healthcare consolidation has reached such a fever pitch that the American Medical Association recently released a new set of physician-employment guidelines designed to protect patients and physicians from potential harm by an organization's business interests. Nonetheless, merger and acquisition activity is expected to continue, leaving physicians concerned about implications, such as patient access and cost of care, which can be higher in hospital-owned practices.
     
  • Physician shortages
    With 30 million new patients expected to enter the healthcare system, doctors worry there won't be enough of them to go around. Playing a central role in the dilemma are primary care physicians, with an estimated shortfall of 52,000 doctors by 2025.
     
  • Loss of physician autonomy
    With business pressures relieved when doctors become employed comes the frequent tradeoff of taking on more red tape as independence is lost. While the AMA guidelines mentioned above seek to put patient needs first, doctors are concerned that those in non-clinical position will hinder their ability to exercise independent medical judgments, according to Healthcare Finance News.
     
  • Administrative burden
    In addition to the coding, documenting and insurance paperwork physicians already face, programs, such as the Meaningful Use incentive program and the impending conversion to the ICD-10 coding system, threaten to overload some practices with work not related to direct patient care.

To learn more:
- see the statement from the Physicians Foundation
- read the article from Healthcare Finance News
- check out the Physicians Foundation's biennial survey, the survey on next-generation physicians and the survey on economic challenges (.pdfs)

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