Imagine someone comes to your job and tells you that if you didn’t start participating in a bunch of government programs then you’re going to get a 9% pay cut. Plus, those government programs add little value to the work you do and it’s going to cost you time and money to meet the government requirements. How would you feel?
To add on top of that, we’re going to create a new system for how you’re going to get paid too. In fact, it’s actually going to be two new systems. One that applies to the old system of payment (which has been declining for years) and a new one which isn’t well defined yet.
Also, to add to the fun, you’re going to have become a collection agency as well since your usual A/R is going to go up as your payment portfolio changes from large reliable payers to a wide variety of small, less reliable people.
I forgot to mention that in order to get access to these new government programs and avoid the penalties you’re going to have to likely use technology built in the 80’s. Yes, that means that it’s built before we even knew what the cloud or mobile was going to be and used advanced technologies like MUMPS.
In case you missed the connection, I’m describing the life of a doctor today. The 9% penalties have arrived. ICD-10 is upon us. ACOs and value based reimbursement is starting, but is not well defined yet. High deductible plans are shifting physician A/R from payers to patients. EHR software still generally doesn’t leverage technologies like the cloud and mobile devices.
All of this makes for the perfect storm. Is it any wonder physician dissatisfaction is at an all time high? It’s not to me. It seems like even CMS’ Andy Slavitt finally realized it with the announcement that meaningful use is dead and going to be replaced. It’s a good first step, but the devil is in the details. I hope he’s able to execute, but let’s not be surprised that so many doctors are unhappy about what’s happening to healthcare.