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Decisions doctors must make to avoid Medicare penalties

A physician’s decision not to report Medicare quality measures or participate in paperless prescribing and health record programs in 2013 will be a costly one in the long run. The programs have been voluntary for the past several years. However, federal laws require Medicare rates eventually to be reduced for physicians who do not participate in the physician quality reporting system as well as the electronic health records and e-prescribing incentive programs. The reason why 2013 is such a critical year for doctors is that Medicare officials are using it as a benchmark for future penalties in all of these programs. The American Academy of Family Physicians estimates that participating in these initiatives next year could save a physician $19,000 in avoided penalties. Successfully reporting quality measures and achieving meaningful use of an EHR in 2013 will prevent a doctor’s Medicare rates from being reduced by 3.5% in 2015 for noncompliance. “It might not seem like th ...

Where growth is coming in telemedicine

Two of the most promising tele-health markets are ones that could have a direct impact on the physician-patient relationship. Research from Frost & Sullivan, a global business research and consulting firm, identified the top 20 tele-medicine markets in terms of size and most impact. Topping the list were home health care and disease management monitoring, and remote doctor and specialist services. Frost & Sullivan ranked the various tele-health markets using a scale of 1 to 10 that took into consideration short-term and long-term revenue opportunity, the stability of the business models and the market’s transformative potential. Home health care and remote services had overall scores of 8.5 and 7.6, respectively. While the Frost & Sullivan report did not give specific monetary growth projections for each sector, it said the top five markets combined generate more than $1.9 billion in annual revenue. Zachary Bujnoch, senior industry analyst for Frost & Sullivan, said home health ...

Doctors in shortage state cite consequences of Medicaid expansion

The Oklahoma State Medical Assn. has concerns about adding 200,000 residents to the state’s Medicaid rolls in 2014 and intends to work with the governor to assess whether such an expansion makes sense. Part of the challenge is determining who these new patients are going to see for their care, said Kenneth King, the association’s executive director. The U.S. Census Bureau has ranked Oklahoma 50th in the nation in terms of physician-to-patient ratio, King said. With the work force already stretched to the limits, physicians barely are able to see the patients they have now, he said. “One of the things we want is to have a dialogue with our governor on how the expansion [is] going to work,” he said. “It’s pretty cynical to say, ‘Yes, you’ve got coverage, but you can’t see a doctor for two years.’ So we’re worried about the work force issue.” The effect an expansion may have on physician payments down the road is another issue the medical society wants to ...