How are States retaining physicians in times of shortage?

Physician shortages is a growing concern and is pushing various states to keep doctors trained in medical schools and residency programs from crossing state lines to practice medicine. According to new statistics from the Assn. of American Medical Colleges- nationwide, there were 258.7 active physicians per 100,000 people and in individual states, ratios range from a high of 415.5 physicians per 100,000 people in Massachusetts to a low of 176.4 per 100,000 in Mississippi. 

In this scenario medical school, hospitals, medical societies and state legislatures are increasingly taking a practical approach to retain the physicians and doctors-in-training in their state. According to a report by AAMC Center for Workforce Studies on average: 

39% of U.S. physicians practice	State where they went to medical school
48% of U.S. physicians practice	State where they completed graduate medical education

Methods adopted by states to retain physicians 

AAMC projections depict that physician shortages nationwide are projected to reach 62,900 doctors by 2015 and 91,500 by 2020 and several states to retain physicians have: 

• Opened new medical schools or expanded existing ones 

• Are offering incentives such as bonuses, scholarships or loan repayment programs to physicians 

• Communities are developing new residency programs with the aim that physicians will develop long-term professional and personal relationships during GME training and keep them from moving out 

• Certain schools’ mission is to train physicians from their states to practice in their states. However states need enough GME training positions else this efforts are wasted as then physicians will shift to another state 

Iowa is below national average retaining 22% of its medical school graduates and 37% of physicians who complete GME training in the state and several efforts in Iowa have been designed to attract physicians to stay in the state. Several other states including Kansas, Mississippi and Alabama offer loan repayment programs for doctors to practice locally. 

In Oklahoma, the state offers scholarships and loans to medical students and residents who agree to practice in rural Oklahoma for a set amount of time. Hence Oklahoma is above national averages, retaining 48% of its medical school graduates and 52% of physicians who complete residency training. 

Physician adapting to this shortage 

Higher revenues and incentives would attract more physicians to the profession and also keep doctors from moving out from states. Healthcare reforms are striving to improve quality of care and physician incentives, to entice more doctors to stay in the profession; but this leaves doctors with little time to balance both patient care and Revenue Cycle Management. As physicians move towards a value based system of healthcare delivery, they would be well-off by partnering with experienced Medical Billing Companies which can offer a balanced approach for both operational as well as revenue maximization. 

Medicalbillersandcoders.com experienced in offering cost-optimizing and revenue-maximizing Medical Billing Revenue Cycle Management in tandem with their goal to assist healthcare should be able to play an essential role in making physicians’ transition towards a value based model easier and profitable, hence also helping towards eliminating physician shortage in the long term.

Medical Billing Companies: Electronic Health Records spurring hiring of staff besides adding to costs at physicians practice

Medical Billing Companies: Electronic Health Records spurring hiring of staff besides adding to costs at physicians practice

Electronic Health Records spurring hiring of staff besides adding to costs at physicians practice

Electronic Health Records (EHRs) are complex systems and a dedicated team of professionals are required for handling and maintaining these systems for smooth operation of such records. The drawbacks of paper based records, the projected advantages of EHRs, and the incentives offered along with the penalties for non-adoption of EHRs are driving hospitals and small practices towards implementing EHR related policies. There are numerous reasons for the slow rate of adoption of EHRs and range from reluctance to accept new technology, the changes brought about by government intervention and practical causes such as financial burdens, increased amount of work and shortage of time. 

Although there are challenges in the initial stages of implementing EHRs, the benefits in the long run are holistic in nature and can benefit physicians as well as consumers. One of the important aspects of the financial and professional growth of the practice is the maintenance of the viability of the equipment and the resources available for efficient operation. One of the important steps in ensuring such efficient operation is the hiring of reliable staff that are not only educated in their own profession  but are also computer savvy and familiar with EHRs and such other systems required for everyday activities. 

Some other factors that may add to the costs are health IT services which are a recurring one along with some other costs such as upgrading the system and keeping the systems secure as per HIPAA guidelines. However, the fact that the initial cost of EHR would be offset due to the incentives provided and the benefits in the long run, financially or otherwise, cannot be denied. The costs of EMR or EHR implementation and maintenance can be reduced by using various methods to streamline the departmental processes by optimizing services such as revenue cycle management and denial management along with numerous other services. These processes require accuracy in order to reduce duplication and rejection of claims, and errors while billing and coding. 

Professional medical billing and coding companies can provide dedicated services such as payment posting, where accurate comprehension of Explanation of benefits (EOB) is required, and accounts receivable where time is the most crucial factor in receipt of accurate reimbursement. Moreover, the advent of EHRs and numerous new polices, physicians are trying to hire more staff for health IT support which is in short supply. Costs of health IT services for upkeep of successful EHRs are rising and some of the ways of cutting costs is to outsource as many departmental processes as possible in order to find relief from some financial burden. 

Medical billing and coding companies that offer specialized services in this field not just cater to physicians’ billing and coding needs but also provide numerous other services. Medical billers and coders at www.medicalbillersandcoders.com offer other value added services such as physician credentialing, consultancy and denial management.

Simplify EHR Systems by Restructuring Your Medical Billing

EHR systems have changed over the last decade and the health reforms have given new meaning to such systems by making rules regarding ‘Meaningful Use” (MU) of such systems. Older versions of EHRs were simple digitized versions replacing paper based records and did not have the specific guidelines in MU to be implemented for the incentives. However, almost all EHR vendors now are MU compliant but only 10.1% of physicians in the country have a fully functional EHR system. This is due to the fact that those who have a basic system are not equipped with features to handle MU compliance along with the changing face of the health industry including the attitudes of payers towards billing processes.

A report prepared by the University of North Texas on providing – Guidance in Documentation, Coding, and Billing of Medical Services for Compliance-  clarifies the documentation and billing requirements and also the general rules to be followed while documenting. For instance – the medical record should be complete without any errors and the documentation of each patient should include the reason for encounter, relevant history, prior diagnostic test results, and physical examination findings. The past and present diagnoses should be accessible to the consulting or treating physician, the patients progress is to be documented and appropriate health risk factors identified. The code reported on the claim form or billing statement needs to be supported by documentation in the medial record.

Hence the requirement for a separate billing system can be felt and is one of the solutions for such complex compliance requirements and the above subset of information can be sent to a billing system designed to specifically handle such information. There are numerous other documentation standards that need to be observed and these standards are easily handled by EHRs and can be made to fit the billing system. The information corresponding to all the documentation standards mentioned above can be sent directly to the billing system at the time of the visit, making the whole process smoother. Moreover, HIPAA compliance can be easily observed because the medical documentation is stored in the billing system and does not require the clerical staff to access the actual EHR.

Billing and related processes need to be reorganized to fit the requirements of not just MU compliant EHR systems but also for accurate and timely reimbursements. These documentation standards and compliance are extremely important in light of the way in which payment models are changing in the industry. Physicians would be paid according to the quality of the service provided and the outcomes rather than the traditional per-patient method. For more information about medical billing processes and to restructure your billing and assistance with EHR implementation, visit www.medicalbillersandcoders.com, the largest consortium of medical billers and coders in the United States that also provides services such as revenue cycle management, denial management, and consultancy.

Medical Billers and coders (MBC) is one of the leading Medical Billing Companies  in USA & help doctors to shortlist Medical Billing Companies, Medical Billing Services  according to their preferences of specialty, city, software and services performed.

Effects on Physicians reimbursements: Insurance Denials and uncertainty of health reforms

Insurance denials are one of the major factors that affect a physician’s revenue even though health reforms do address some issues faced by patients and physicians in dealing with insurance companies, the denial rate of claims has not significantly altered due to such reforms. These insurance denials are avoidable especially as they create problems for physicians and providers and delay or even eliminate the possibility of proper provider reimbursement. Dealing with insurance companies is tough enough for experienced physicians; it is even tougher for new physicians who have limited hands-on experience in such matters.

The reforms have played a significant role in reining in insurance companies and some of these policies may work but still remain to be fully tested. The survey conducted by The United States Department of Health and Human Services finds that the rate of denial is 19% but the denial rate increases with the age group of the patient. People who are older face more denials compared to young individuals and this is a worrying trend for a population which is continuously aging. The Government Accountability Office (GAO) has released a report on insurance denials which sheds some light on the nature of insurance denials- it states that in many cases the denied claim, if appealed, is often reversed. This survey also clarifies that the number of denials due to the inappropriateness of the service provided by the physician are less than those because of billing errors and eligibility issues.

The health reforms are going to  affect the insurance scenario in the sense that as now even people with pre-existing conditions can get insurance- this essentially means that physicians are more likely to see increased number of sick patients which in turn would increase the average physician-patient encounter time. The other aspects that will affect the insurance scenario in the country are that since there would be a large influx of consumers in the form of the previously uninsured 32 million Americans which would benefit the insurance companies to grow. However, initially insurance providers would see a drop in their revenue due to decreased profits and increasing number of claims.

Physicians and providers stand to gain from the health reforms in the long run and the way in which these new policies will affect payers even though some payers may decrease the Physician Reimbursement amount. Nevertheless, insurance denials are always going to be one of the major problems that providers will have to face in the future even after the implementation of reform policies.

The best way to deal with insurance denials is to ensure that denial management and payer interaction are performed by experienced professionals for better results. Such denial management and payer interaction can be performed in a professional and efficient manner by the largest consortium of medical billers and coders in the United States, medicalbillersandcoders.com Billers and coders in the consortium can not only assist in better Denial Management and payer interaction but also offer numerous other value added services such as revenue cycle management, research, and consultancy.