Changes in the medical field such as the implementation of the Affordable Care Act and the upcoming ICD-10 transition deadline are creating new challenges for physicians in 2015. These new obstacles impact physicians in many ways, particularly financially. Medical Economics’ article, “Top 15 Challenges Facing Physicians in 2015,” outlines some of these major issues in order to help physicians prepare themselves for these challenges in order to overcome them and maintain their thriving medical practices.

From this article, Scott Public Relations created two blogs, summarizing the ten most prevalent challenges facing physicians in 2015.

Below are the first five challenges:

  1. The implementation of ICD-10 in October. The American Medical Association estimates that the implementation cost of this coding system for small practices could range between $56,000 and $226,000. In order to combat these costs, experts recommend that practices have a financial plan ready in the event that payments are slowed down for a significant length of time.
  2. Continuing to uphold HIPAA standards. Since 2009, there have been over eight hundred breeches of the Health Insurance Portability and Accountability Act, and the Office of Civil Rights is currently in its second phase of HIPAA audits. Fines for these violations can range anywhere from $100 to $50,000. With the growth of social media usage at work, these breeches are becoming more common. It is important for physicians and employees alike to be aware of what constitutes a HIPAA violation.
  3. Getting paid under the Affordable Care Act. The ACA is shifting how physicians are reimbursed for their services. Rather than a fee-for-service model, physicians will be paid under a value-based model. This will be particularly challenging for physicians who work with Medicare patients. Under this act, physicians are required to utilize the Physician Quality Reporting System (PQRS), and Medicare has proposed that “those who are not deemed successful participants for the 2013 program year will face a 1.5 percent penalty in Medicare payments in 2015 and two percent thereafter.” The ACA will also be problematic as physicians begin to see an increase in claim denials.
  4. Maintenance of the American Board of Internal Medicine’s Maintenance of Certification (MOC) program. The monetary and time requirements for this program are extensive, and some argue that the test material is irrelevant to their field. The controversy over this program stems from the changes to the accreditation process in 2014, which many physicians disagreed with. In response, the American College of Physicians has developed an interactive tool, the ACP MOC Navigator, which physicians can use to help prepare for their examinations.
  5. Collecting co-pays and deductibles from patients. Under the Affordable Care Act, patients have a ninety-day window to pay their premiums, and physicians are beginning to suffer. Some patients take advantage of medical services without paying their premiums, and it is difficult for physicians to collect. Physicians can limit the negative effects of this policy by collecting co-payments at the time of service and including easy-pay options such as online bill pay and automated payment plans. Government agencies such as Medicaid can also take a significant amount of time to pay for claims. Physicians should safeguard against Medicaid claim denials going forward to prevent financial loss.

Have you faced any of these issues in your own practice?

Stay tuned for our second blog on additional challenges physicians are facing.

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