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Increasingly, Physician Practices Paying Fees To Receive Electronic Payments

Posted on October 13, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Virtually no one would argue that health plan reimbursement levels are particularly high. Adding a fee if they want to get paid electronically seems like adding insult to injury, doesn’t it?

Unfortunately, one in six medical practices report being hit with these charges, according to research by the Medical Group Management Association. Its recent survey found that some practices are paying a meaningful percentage of total medical services payments to get paid via Electronic Funds Transfer (EFT).

Under rules created by the Affordable Care Act, designed to decrease healthcare administrative overhead, CMS created a standard for EFT transactions. Health plans have been required to offer EFT payments if providers request it since 2014.

Health plans’ payment policies seem to vary, however. A recent MGMA Stat poll, which generated responses from more than 900 medical practice leaders, found that while 50% of practices were not paying fees for receiving payments via EFT, others are absorbing big surcharges.

For one thing, health plans are increasingly offering practices a “virtual credit card” they can use to receive payments. While 32% of MGMA respondents said they weren’t sure whether they paid an electronic payments fee or not, other research suggests that many practices end up using virtual credit cards without knowing they would be charged 3-5% per payment received.

Meanwhile, 17% of respondents told MGMA they were definitely paying transaction fees, and of that group, almost 60% said that the health plans in question used a third-party payment vendor.

MGMA sees this as little short of highway robbery. “Some bad actors are fleecing physician groups by charging them to simply receive an electronic paycheck,” said Anders Gilberg, MGMA’s senior vice president for government affairs.

The MGMA is asking CMS to issue guidance preventing health plans and payment vendors from charging EFT-related fees. The group argues that such fees are counter to the goal of reducing healthcare administrative complexity, the stated purpose of requiring health plans to offer EFT payments.

Also, the American Hospital Association and NACHA, the electronic payments association, are asking CMS to set standards on when and how health plans can implement virtual cards, as well as making it easy for practices to move to EFT.

The imposition of fees is particularly unfair given that health plans benefit significantly from issuing EFT payments, the group says. For one thing, health insurers save millions of dollars by sending payments via EFT, MGMA notes. Not only that, sending payments via EFT allows health plans to automate the re-association of electronic payments with the Electronic Remittance Advice.

While it’s true that physician practices used to save time staff would’ve used to manually process and deposit paper checks, that doesn’t make the fees okay, the group argues. “Beyond the material administrative time savings for all sides, the time and resources that physician practices spend on billing and related tasks are better spent delivering healthcare to patients,” it said in a prepared statement.

Embracing Quality: What’s Next in the Shift to Value-Based Care, and How to Prepare

Posted on June 13, 2017 I Written By

The following is a guest blog post by Brad Hill, Chief Revenue Officer at RemitDATA.

Whatever the future holds for the Affordable Care Act (ACA), the shift to value-based care is likely here to stay. The number of providers and payers implementing value-based reimbursement contracts has grown steadily over the past few years. A survey of 465 payers and hospitals conducted in 2016 by ORC International and McKesson revealed that 58 percent are moving forward with incorporating value-based reimbursement protocols. The study, “Journey to Value: The State of Value-Based Reimbursements in 2016” further revealed that as healthcare continues to adopt full value-based reimbursement, bundled payments are the fastest growing with projections that they will continue to grow the fastest over the next five years, and that network strategies are changing, becoming narrower and more selective, creating challenges among many payers and hospitals as they struggle to scale these complex strategies.

Given the growth of adoption of value-based care, there are certainly many hurdles to clear in the near future as policymakers decide on how they plan to repeal and replace the ACA. A January 2017 report by the Urban Institute funded by the Robert Wood Johnson Foundation revealed that some of the top concerns with some potential scenarios being floated by policymakers include concerns over an immediate repeal of the individual mandate with delayed repeal of financial subsidies; delayed repeal of the ACA without its concurrent replacement; and a cutoff of cost-sharing subsidies in 2017.

With the assumption that value-based healthcare is here to stay, what steps can you take to continue to prepare for value-based payments? The best advice would be to continue on with a “business as usual” mindset, stay focused and ensure all business processes are ready for this shift by continuing to:

  1. Help providers establish baselines and understand their true cost of conducting business as a baseline for assuming risk.
  2. Analyze your revenue cycle. Look at the big picture for your practice to analyze service costs and reimbursements for each – determine if margins are in-line with peers.  Identify internal staff processing time and turnaround times by payer. Evaluate whether there are any glaring issues or problems that need to be addressed to reduce A/R days and improve reimbursement rates.
  3. Determine whether there are reimbursement issues for specific payers or if the problem is broader in nature. Are your peers experiencing the same issues with the same payers?
  4. Capture data analysis for practice improvement. With emerging payment models, hospitals and practices will need expertise in evaluating data and knowledge in how to make business adjustments to keep the organization profitable.
  5. Determine how you can scale and grow specific payment models. Consider, for example, a provider group that maintains 4 different payment models and 10 different payers. The provider group will need to determine whether this system is sustainable once payment models shift.
  6. Break down department silos in determining cost allocation rules. Providers need a cost accounting system that can help determine exact costs needed to provide care and to identify highest cost areas. Cost accounting systems are typically managed by the finance team. There needs to be clinical and operational input from all departments to make a difference. Collaborate across all departments to determine costs, and design rules and methodologies that take each into account.
  7. Compare your financial health to that of your peers. Comparative analytics can help by giving you insights and data to determine your practice’s operational health. Determine whether you are taking longer to submit claims than your peers, have a higher percentage of denied claims for a specific service, percentage of billed to allowed amounts and more.

Though change is a part of the healthcare industry’s DNA, ensuring business processes are in line, and leveraging data to do so will help organizations adapt to anything that comes their way.

Advanced APM Timeline – MACRA Monday

Posted on December 5, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program.

Last week we posted about the APM Expansion in MACRA and the new PTAC Committee. Today we’ll dive into the timelines for APMs. They can get pretty confusing, so hopefully after you read this post you’ll have a better idea on how the APM timelines work.

Before we dive into the timelines, I also wanted to make a quick note of the benefits related to participating in an APM. The APM benefits really didn’t change in the MACRA final rule so our previous post on Advanced APM incentives is still accurate as well.

As we noted before, participating as an advanced APM provides incentives on top of whatever rewards are part of your original APM agreement. Under MACRA, you just get an extra 5% bonus on top of your pre-MACRA rewards for being in an APM. Here are the 3 main benefits of participating as an advanced APM under MACRA:
advanced-apm-benefits

As far as reporting as an Advanced APM, CMS will take three “snapshots” on March 31, June 30, and August 31 in order to determine which eligible providers are eligible as an Advanced APM and meet the thresholds to become a Qualified APM participant.

Here’s the official timeline details from CMS:

cms-apm-determination-timeline

At point B, the snapshots are taken to determine eligibility and at point D in the graph above, eligible providers will be notified of their APM eligibility. Yes, this is a very compressed timeline, so it behooves you to get started early. Remember that if you don’t qualify as an Advanced APM, then you still have to participate in MIPS.

The timeline for paying the 5% reward for being part of a qualified Advanced APM is still 2019 for reporting year 2017. 2018 reporting year will determine payouts for 2020 and so forth. That’s no change from the proposed MACRA rule.

Be sure to check out all of our MACRA Monday blog posts where we dive into the details of the MACRA Quality Payment Program.

APM Expansion and New PTAC Committee – MACRA Monday

Posted on November 28, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program.

Most of the general details about APMs was changed in the final rule (See our previous post about APMs and whether you should take part in an APM or MIPS within MACRA). However, if you want to dive into the details of APMs, then check out this CMS webinar and slides that dive into the APM program. One thing that didn’t change much yet is the types of programs that counted as possible advanced APMs:

  • Shared Savings Program (Tracks 2 and 3)
  • Next Generation ACO Model
  • Comprehensive End Stage Renal Disease Care Model (Two-Sided Risk Arrangements)
  • Comprehensive Primary Care Plus (CPC+)
  • Oncology Care Model (OCM) (two-sided risk track)

However, as CMS mentioned previously, their goal is to get more and more people involved in the APM program. As part of that effort, a number of other programs are likely to be eligible as an advanced APM in 2018:

  • Comprehensive Care for Joint Replacement (CJR) Payment Model (CEHRT)
  • Advancing Care Coordination through Episode Payment Models Track 1 (CEHRT)
  • ACO Track 1+
  • New Voluntary Bundled Payment Model
  • Vermont Medicare ACO Initiative (as part of the Vermont All-Payer ACO Model)

In fact, some of these might even be available in 2017. The MACRA final rule also created a new committee called the PTAC (Physician-Focused Payment Model Technical Advisory Committee). This committee will accept suggestions on other programs that should be considered an advanced APM. Then, they make recommendations to the HHS secretary on which programs should be added as Advanced APMs.

All updates on programs that qualify as an Advanced APM will be available on the CMS Quality Payment Program (MACRA) website.

Be sure to check out all of our MACRA Monday blog posts where we dive into the details of the MACRA Quality Payment Program.

What Will Be Trump’s Impact on MACRA? – MACRA Monday

Posted on November 21, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program.

Next week we’ll be kicking off our weekly series of details from the MACRA Final Rule. However, before we start going through the changes and what you need to know about MACRA, I wanted to cover an important topic of concern for many practices. I’ve heard a lot of practices that are afraid of what they consider the uncertain future in the coming Trump presidency.

While I believe that healthcare could see significant impact from a Trump presidency, I don’t believe that MACRA will be impacted by the change in presidency. First, MACRA was as bipartisan as you could find in Washington DC. Even if Trump wanted to replace, modify, repeal MACRA, I can’t imagine it getting enough support in the senate and house. If this is true, Trump won’t even try to do anything with MACRA. Second, Trump has plenty of bigger fish to fry. When you look at the various priorities that Trump has said he has for his presidency, nothing indicates that MACRA will be anywhere near those priorities. Third, it’s hard for me to imagine that Trump would see a problem with the move to technology in healthcare.

What also is worth noting is that MACRA is separate from ACA (aka Obamacare) and even ARRA (the HITECH Act). I’ll leave the predictions for what will happen with ACA for other people. I have no doubt that ACA will be impacted by the change in presidency, but even if they did a full repeal of Obamacare (which looks like it’s impossible), MACRA will still remain and be in force. If MACRA was part of Obamacare, I’d have a different view, but since it’s not then I think MACRA will continue forward as planned.

Those of you hoping for MACRA to disappear due to the new president and those of you waiting for MACRA to change after the comment period is over are grasping at straws. Love it. Hate it. Feel however you may about MACRA, I really don’t see any scenario where MACRA is not part of the future of healthcare.

What do you think? If you disagree, I’d love to hear why in the comments. If you agree, I’d love to hear from you as well. With that view, we’ll be continuing MACRA Monday blog posts for the foreseeable future so that our readers are ready.

Be sure to check out all of our MACRA Monday blog posts where we dive into the details of the MACRA Quality Payment Program.

We’re Just Getting Started with an Internet of Healthy Things (Part 1 of 3)

Posted on November 24, 2015 I Written By

Andy Oram is an editor at O’Reilly Media, a highly respected book publisher and technology information provider. An employee of the company since 1992, Andy currently specializes in open source, software engineering, and health IT, but his editorial output has ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. His articles have appeared often on EMR & EHR and other blogs in the health IT space.

Andy also writes often for O’Reilly’s Radar site (http://oreilly.com/) and other publications on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O’Reilly’s Open Source Convention, FISL (Brazil), FOSDEM, and DebConf.

The release of Joseph Kvedar’s book The Internet of Healthy Thingscoincided with the 15th annual symposium on Connected Health, which he runs every year and which I reported on earlier. Now, more than ever, a health field in crisis needs his pointed insights into the vision widely shared by all observers: collaborative, data-rich, technology-enabled, transparent, and patient-centered.

The promise and the imminent threat

A big part of Dr. Kvedar’s observations concern cost savings and “scaling” clinicians’ efforts to allow a smaller team to treat a larger community of patients with more intensive attention. As I review this book, shock waves about costs are threatening the very foundations of the Affordable Care Act. Massive losses by insurers and providers alike have led to the abandonment of Accountable Care Organizations by many who tried them. The recent bail-out by UnitedHealth was an ominous warning, eagerly jumped on by Fox News. Although other insurers issued assurances that they stay with the basic ACA program, most are reacting to the increased burden of caring for newly signed up patients by imposing insufferably high deductibles as well as extremely narrow networks of available providers. This turns the very people who should benefit from the ACA against the system.

There is nothing surprising about this development, which I have labeled a typical scam against consumers. If you sign up very sick people for insurance and don’t actually make them better, your costs will go up. T.R. Reid averred in his book The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care that this is the sequence all countries have to follow: first commit to universal healthcare, then institute the efficiencies that keep costs under control. So why hasn’t that happened here?

Essentially, the health care system has failed us. Hospitals have failed to adopt the basic efficiency mechanisms used in other industries and still have trouble exchanging records or offering patients access to their data. A recent study finds that only 40% of physicians shared data within their own networks, and a measly 5% share data with providers outside their networks.

This is partly because electronic health records still make data exchange difficult, particularly with the all-important behavioral health clinics that can creat lifestyle changes in patients. Robust standards were never set up, leading to poor implementations. On top of that, usability is poor.

The federal government is well aware of the problem and has been pushing the industry toward more interoperability and patient engagement for years. But as health IT leader John Halamka explains, organizations are not ready for the necessary organizational and technological changes.

Although video interviews and home monitoring are finding footholds, the health industry is still characterized by hours of reading People magazine in doctors’ waiting rooms. The good news is that patients are open to mobile health innovations–the bad news is that most doctors are not.

The next section of this article will continue with lessons learned–and applied–both by Dr. Kvedar’s organization, Partners Connected Health, and by other fresh actors in the health care space.

Economists Display What They Don’t Know About the Health Care Industry

Posted on October 7, 2015 I Written By

Andy Oram is an editor at O’Reilly Media, a highly respected book publisher and technology information provider. An employee of the company since 1992, Andy currently specializes in open source, software engineering, and health IT, but his editorial output has ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. His articles have appeared often on EMR & EHR and other blogs in the health IT space.

Andy also writes often for O’Reilly’s Radar site (http://oreilly.com/) and other publications on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O’Reilly’s Open Source Convention, FISL (Brazil), FOSDEM, and DebConf.

Recently, I resorted to a rare economic argument in a health IT article, pointing out that it’s unfair to put the burden of high health care costs on the patients. Now 101 economists have come out publicly recommending that very injustice. Their analysis shows the deep reluctance of those who are supposed to guide our health care policy to admit how distorted the current system is, and how entrenched are the powerful forces that keep it from reforming.

My argument cited numerous studies and anecdotal reports to show the deplorable record of the US health care industry regarding costs: providers who don’t reveal prices, providers who don’t know what the patient’s out-of-pocket costs will be, wrenching differences in insurance payments for the same procedure, missing quality information that consumers would need to make fair comparisons, and more. Just as icing on the cake, the most recent Consumer Reports (November 2015) offered a five-page article on all the screw-ups that lead to medical “sticker shock.”

Probably I’m foolish to launch an economic argument with the distinguished signers of the brief letter to key members of Congress. The signers’ credentials are impeccable, placing them in an impressive list of universities and think tanks–all of which, I’m sure give generous coverage for any health care these economists need. If any of the signers should be burdened with the Cadillac tax, they could cover it with an extra consulting gig at the World Bank. (What’s the economics behind “nice work if you can get it”?)

But the economists just aren’t facing realities in the health care industry. Let’s expand their telescoped argument, full of assumptions and leaps of faith, to see what they’re saying.

First, they expect that the Cadillac tax will not be quietly absorbed by firms wooing professionals in high demand (such as health IT developers), but will drive those firms to reduce coverage. The burden will explicitly fall on the individual patient. I suspect that many firms facing staff shortages would just compensate key high-performers for the high-cost health coverage, but let’s accept the economists’ assumption and move on.

Next, the economists assume that the patient will make rational choices leading to what they call “cost-effective care.” What could such choices be?

Can the patient tell her doctor that a certain test is unnecessary, or that a certain treatment is unlikely to improve her condition? Does the patient know that the test has too many false positives, or is unlikely to add to the doctor’s knowledge? These questions lie precisely within the expertise of the provider, not the patient.

Can the patient determine whether a high-cost drug will pay for itself in reduced future health care and improved quality of life? This calls for extended longitudinal research.

Can the patient tell her provider or insurer to adopt a rigorous pay-for-value regime? If she goes looking for an ACO, will it actually gather enough data to treat her efficiently, and does it truly get rewarded for doing so? These are nation-wide policy issues outside the patient’s control.

As I pointed out in my earlier article, the patients lack the information needed to compare the costs and quality of procedures from different providers. Patients try to do so, but data is inadequate. Nor will yelling and screaming about it make any difference–we’ve all known about the problem for years and it hasn’t made much difference so far.

I don’t like dumping on economists. After all, they rarely cause the problems of the world, and are all too often tasked with solving them. The perennial occupational hazard of the economist is to be forced to make recommendations on the basis of insufficient knowledge.

But in this case, the average patient has knowledge that these economists lack. The problems are also well known to anyone in the health care industry who has the courage and clarity of vision to acknowledge what’s going on. If we want the system to change, let’s put public pressure on the people who are actually responsible for the problems–not the hapless patient.

Healthcare Costs and the New Cost Conscious Patient

Posted on June 30, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

My favorite health economist, Jane Sarasohn-Kahn, has put out a really interesting post on her Health Populi blog talking about what the SCOTUS ACA ruling means for health consumers (Side Note: Here’s the lesson I took from the ruling.). Jane offers an important perspective that we should think about as we look to the future of healthcare. Here’s an excerpt from her article:

There are still tweaks and adjustments to be made to the law, and market supports that must deal with the ever-rising price of health care. While optimists report health care cost increases moderated to 6.5% in 2015, this growth rate is nonetheless many times greater than peoples’ wage increases (relatively stagnant for a decade) and the Consumer Price Index which in the previous year was actually negative (due to lower costs of petrol and other decreasing costs in the household budget). The one cost households can count on going up, up, up is….healthcare.

And so with the growth of high-deductible health plans and health savings accounts, health consumers must become health care shoppers — that is, if people want to gain some control over their financial wellness.

What does this new cost conscious patient mean for healthcare? What systems are we going to need to be able to handle the patient? Will we be able to continue providing care to patients without any real idea on how much that care will cost? Or will we need systems that help us know what the cost of care will be so the patient can choose to buy that care or not? Will cost conscious patients want to be kept well instead of just having their current complaint treated?

There are these and a lot of other questions that are raised by this shift in patient consumption of healthcare services. Understanding these changes is going to be extremely important for healthcare organizations to survive.

Do Doctors Care About the Triple Aim?

Posted on May 13, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The stated goal of Patient Protection and Affordable Care Act (PPACA) (i.e. Obamacare) and healthcare reform is what people like to call the Triple Aim. For those not familiar with it, it goes as follows:

  • Improve patient satisfaction and quality of care
  • Improve the health of the community/population
  • Reduce the cost of healthcare.

I’ve regularly heard people reference the triple aim as a reason why we should act a certain way. They refer to the triple aim as the main goal of what we are doing with healthcare IT. It’s the unifying vision for which all of healthcare wants to achieve.

I’m here to tell you that it’s just not the case. There are plenty in healthcare that couldn’t care less about the triple aim of healthcare. Many in that group are doctors. Ok, maybe the word “care” isn’t the right one. They do care about patient satisfaction and quality of care. They do want the health of their community to be better. They do want the costs of healthcare reduced. They do care about those things, but do they care to the point where it will actually spur action?

Another way to look at this is do they care about the triple aim enough for them to change what they’re doing. Plus, do they care about other things more than the triple aim.

Let’s look at them backwards. Do doctors want to reduce the cost of healthcare? As citizens, of course they want the cost of healthcare reduced, but with one small caveat: As long as it doesn’t mean I get paid less. This isn’t a knock on doctors either. This is the perfectly rationale response to the idea of lowering costs in healthcare. It’s not something we should criticize. It’s something we should understand and apply to whatever we’re trying to achieve.

The same thing applies to improving the health of a community or population. Hopefully the shift to value based reimbursement, population health, and ACOs will help to realign the incentives to make it so doctors care more about this than they do now. Otherwise, many of these programs look like we’re asking our providers to provide more free work for the benefit of the community. Hard to blame them when you phrase it like that, no?

The majority of doctors embrace this first aspect of the triple aim. They really want to provide the very best care they can to the patients (with a few sad exceptions which give a bad name to the hundreds of thousands of doctors who are doing their best). The question I’d ask ourselves is are we putting doctors in a position where they can have satisfied patients who receive quality care or are we burdening our highest paid resource with tasks that don’t work towards this end goal? Every doctor I know would welcome the opportunity to have better satisfied patients and improved outcomes.

I love the components of the Triple Aim as an ideal, but as it is today I think there’s a misalignment between the ideal and the day to day reality for doctors. I’m not against being idealistic and ambitious in our goals. Although, don’t expect our healthcare system to reach the triple aim if we don’t realign the incentives. Plus, let’s not forget that not all incentives are financial.

HealthCare.gov

Posted on December 26, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

If you haven’t been to HealthCare.gov for a while, go and check it out. If you didn’t know better, you’d think that HealthCare.gov was built by a company and not the government. This is true all the way down to the HealthCare.gov Blog featured on the home page. I applaud Todd Park and the others at HHS who took a different approach to how a government website should look and feel. They even have a scrolling set of stories about patients and benefits. You’d think they have something to sell us.

Well, I guess they do have something to sell. They are definitely trying to sell us on ACA (aka Obamacare) and the benefits that come from Obamacare. Although, the tools that I found most interesting were the Insurance Options Wizard which walks you through all the options you have to getting insurance. Not to mention a whole set of tools to try and help people understand using insurance. Although, I’m pretty sure most of that’s not going to be read. So, hopefully it’s got a good dose of search engine optimization applied so that it will show up in search engines where it might get a chance at being read.

We’ve written about the “Comparing Care Providers” part of HealhCare.gov before. It’s pretty gutsy for a government organization to go there at all. Certainly they are taking a pretty high level approach to their “comparison” but we’ll see how much they dig into it going forward. Will those doctors that are part of an ACO that’s striving to be reimbursed on the quality of care be listed different than other doctors? It will be interesting if tools like these start to differentiate which patients go to which providers.

I do wish that the website did more to get patients involved in their healthcare. Here’s what I said in my “All I Want for Christmas…” post on EMR & HIPAA:

More Empowered and Trusted Patients – Imagine where the patient was a full participant in their healthcare. That includes being trusted and listened to by their doctor and a patient who thoughtfully considers and listens to their doctor. This is not a one sided issue. This is something that both patients and doctors can improve. There are as many belligerent patients as their are arrogant doctors. We need a good dose of humility, care and trust re infused into healthcare. I think they only way we’ll get there is for the lines of communication to open up on an unprecedented level.

Seems like HealthCare.gov is one place that could help reach this goal. I guess in some ways the physician comparison engine could work towards this. How cool would it be if they listed which of the physicians used EHR and which EHR that physician used? Reminds me of “Got EMR?” ad campaigns I first wrote about about 6 years ago.

EMR or Not, we’re quickly heading to a world where doctors are differentiated on the technical services they provide their patient. Doctors are starting to be judged by their medical website and the services they provide on that website. Do they accept online appointment requests? Do they accept online payments? Can the patient communicate electronically with the clinic? Can the patients receive their patient records electronically?

It will start with a handful of doctors and then start to spread. Plus, it will be accelerated if HealthCare.gov or some other website starts to highlight those doctors who offer these type of services and those that don’t.