The healthcare system is definitely in a turmoil with political changes and new regulations, among others. Physicians are facing challenges that they are not equipped to deal with, nor often know how to approach them in the first place.
The changing healthcare environment is driving physicians towards administrative bureaucracy, reimbursements, and others, and away from patient care. These challenges are deterring from what they signed up to do in the first place, which is care for patients.
The MIPS portion of MACRA has put many physicians on edge, especially as 2017 is a transition year and makes it all new for everyone. What measures do I need to meet? Which categories are worth more? These are some important questions that need not only time to research and understand, but also require the knowledge and resources to meet these categories and file for them in the proper way.
Medicare has weighed Resource Use at 0%, augmenting the clinical Quality Measures to 60% for the year 2017. Physicians can choose from a wide array of quality measures and then submit them for performance calculations. Clinical Improvement Activities, worth 15%, are calculated based on the performance of four out of the proposed 94 individual Clinical Practices Improvement Activities (CPIA).
Perhaps the most complicated of the categories is Advancing Care Information. The performance of this category is calculated based on five EHR use measures. These include e-prescribing, patient access and security risk analyses.
Needless to say, MACRA and MIPS have thrown many for a loop and taken up valuable resources for physicians and practices.
Patients have grown to expect certain things from their clinic and their physician. Long wait-times and difficulty booking appointments have made many switch to other providers with a more modern twist on care.
With a growing number of physicians offering services such as telemedicine, patients can skip the waiting room and connect with their doctor when it is convenient for them. An American Well survey revealed that 50 million patients would be willing to switch to a provider that offers telemedicine services over regular in-office visits. That number grew from 17 million in 2015, reinforcing the fact that telemedicine is becoming more and more popular.
Patients want better access to care in a way that reflects the more modern world they live in, putting pressure on physicians and clinics to step up their game when it comes to patient experience.
The move from quantity to a more quality-based care has a lot of physicians at a loss. Have they always provided good care? Of course. Have their patients always listened to their recommendations? Of course not.
This can be attributed to a lack of financial funds to pay for prescriptions or others, or even a desire to put their money elsewhere. Sometimes, a doctor’s priority of keeping their patients healthy is not always reciprocated by the patient themselves, leading to doctors being penalized for a lack of effort not on their part, but on their patient’s.
The question remains, how can doctors get their patients to show up to cancer screenings or follow-up with their recommendations for patients with diabetes and other conditions? The metrics needed to be met can sometimes require a lot of effort and resources that many don’t have. Services such as chronic care management can help for certain aspects of keeping track and ensuring recommendations are being met.
Electronic health records allow physicians to easily access and keep track of patient data, medical history, notes and others. However, needing to send information to a specialist or other still requires most to send information by fax, even in 2017. On top of this, information sent electronically sometimes needs to be resubmitted into another EHR or record database.
A study by KLAS Research shows only 6% of medical professionals can easily transmit information to a colleague using a different EHR than their own. The lack of EHR interoperability will not likely be solved soon, frustrating physicians, clinics and hospitals trying to find the best solutions.
Patient satisfaction has been weighing down on physicians. With new government regulations, satisfaction rates are directly impacting the way physicians are treated by both their clinic and insurers.
Oftentimes, this leads many to conduct patient satisfaction surveys, trying to find common ground with patients, but rarely having the manpower, technology or resources to truly answer the growing patient needs.
Surprisingly, the emphasis on patient satisfaction has led physicians to over test to ensure the best care or prescribe high dose drugs for pain.
A study on the Impact of patient satisfaction ratings on physicians and clinical care shows that of the 155 physicians who responded, with 85% working in a solo or private practice:
’59% reported that their compensation was linked to patient satisfaction ratings; 78% reported that patient satisfaction surveys moderately or severely affected their job satisfaction; […] Almost half believed that pressure to obtain better scores promoted inappropriate care, including unnecessary antibiotic and opioid prescriptions, tests, procedures, and hospital admissions.’
Not only do these impede on their work, but they are often left juggling with problems not linked to patient care, such as administrative burdens, changing government regulations, and others. If 2017 is an indication of anything, it’s that physicians will continue to face interoperability problems and need to expand the services they offer to meet the healthcare experience their patients now expect.