The Department of Health and Human Services (HHS) announced recently that nationwide, 77.8 million consumers saved $3.4 billion up front on their premiums as insurance companies operated more efficiently. Additionally, consumers nationwide will save $500 million in rebates, with 8.5 million enrollees due to receive an average rebate of around $100 per family.
This report includes the 2012 health insurer data required under the Affordable Care Act’s Medical Loss Ratio, or “80/20 rule.” The report shows that, compared to 2011, more insurers are meeting this standard and spending more of their premium dollars directly toward patient care and quality, and not red tape and bonuses.
Staying with the theme of practice models for independent physicians, here’s an interview with Samir Qamar, MD of MedLion.
Mary Pat: You are the Founder and Chief Executive Officer of MedLion, as well as a practicing Family Physician. Tell us your story.
Dr. Qamar: I grew up around the world the son of a UN diplomat, with a lot of time spent in Europe (including medical school). Growing up, I always wondered why most Europeans never needed insurance for basic medical care. I also learned a lot about the pros and cons of government-run health systems.
At Wake Forest Baptist Medical Center in Winston-Salem, North Carolina, doctors are saving time and sharing ideas using Box, a file-sharing and collaboration software that lets providers browse available medical documents and communicate with each other about treatment options. We are big believers in Box at Manage My Practice – we use it, and most of our clients end up using it too. Box is the only HIPAA-compliant file storage and collaboration service, and just like the doctors at Wake Forest, it makes our lives easier countless times a day. Wake Forest uses Box to store all of their medical journals and articles, as well as commenting on each file so that physicians can discuss procedures and treatment options. The doctors can access the repository from their tablets and smartphones, so that accessing detailed disease or treatment information is always as close as their mobile device.
Box is a simple and secure solution for sharing content with your coworkers, customers and audience. If you have moved your organizations’s practice management, electronic health record or email service to “the cloud” then it only makes sense to move your paperwork and content out of boxes and storage and into the cloud as well. If you have are using email attachments, a network drive, FTP server, or a non-compliant solution like Dropbox, then switching to Box can help your practice reduce your liability, stay HIPAA compliant, and store all of your digital content in a secure and accessible manner.
Box also makes mobilizing your workforce across locations easy. Box means your content is always available in a web browser, a phone or tablet, or synced on your desktop. Many of our consulting clients also use it to coordinate work and file across locations. If you have outsourced your billing or human resources, a shared folder in Box allows both locations to have the latest information and stay in touch.
Manage My Practice is a Certified Box Reseller, and would love to help you leverage Box to improve your practice’s workflow.
This is no April Fool’s Joke for medical practices and providers: starting Monday, April 1st, we will face a 2% cut in reimbursement for services due to the “sequester.” The sequester is the other half of the “fiscal cliff” that we reported on back in January. Although not too long ago, all the conventional wisdom was dead set against the government “going over the cliff,” and here we are with both automatic tax hikes and spending cuts now a reality.
Managers might find themselves giving the same explanations about gridlock to the doctors that you gave your employees when their first paycheck of 2013 was lower than usual.
Although the cut is only 2%, it comes entirely from the 80% of the allowable that the government reimburses, as opposed to the 20% patient responsibility. The cut does not affect the Medicare patient’s co-insurance, not does it affect the 2013 Medicare Part B deductible.
To give medical practice managers an idea of what that cut will look like, here are some sample numbers.
Most readers know that I have a special interest in helping physician practices survive and thrive, and have been writing recently about different models of care that physicians are adopting to make private practice financially viable. Here’s an interview with Scott Borden of Direct Pay Consulting, who helps practices convert to a Direct Pay Model. ~ Mary Pat Whaley
Mary Pat: What is your background, Scott?
Scott: I am a passionate Health Savings Account (HSA) expert. My background has been in health insurance marketing and management for 23 years. I have been heavily involved with Consumer Driven Healthcare for the past 15 years. I have been both a talk radio show host and guest on hundreds of shows over the past 8 years. I have also been featured on several television broadcasts and been a guest speaker for dozens of organizations.
Mary Pat: Your company is called Direct Pay Consulting and you help primary care practices transition to a Direct Payment Care (DPC) model – will you explain what that model is? (more…)
The HIMSS13 Conference in New Orleans, one of the biggest gatherings of Health Information Technology professionals of the year, was host to speakers, panel discussions, and one pretty large announcement from some of the big names in the electronic health record industry.
What is Medicaid?
Medicaid provides health and long-term care financial assistance for certain groups of people with limited income. Medicaid was enacted under title XIX of the Social Security Act as a joint program between the Federal government and all 50 states, the District of Columbia, and the U.S. Territories.
Medicaid became effective January 1, 1966, and currently is the largest source of medical and health-related funding for America’s poorest people. The Federal agency that administers the Medicaid program is the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health & Human Services.
Medicaid programs differ in each state.
Welcome to our guide to Healthcare Buzzwords!
An acronym for “Accountable Care Organization”, an ACO is a model of healthcare delivery in which a group of healthcare providers agree to accept payment for their services based on the aggregated health outcomes of the patients they see, as opposed to the total number of services performed. ACOs reward providers in a “fee for health” model, as opposed to a traditional “fee for service” model. Although the term ACO can apply to a variety of types of organizations, regulations for establishing ACOs to participate in the Medicare Shared Savings Program specifically were included in the Patient Protection and Affordable Care Act of 2010.