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CMO: Reimbursement, Alignment and Burnout Among Challenges for Facilities and Physicians in 2016

Posted on Tue, Dec 15, 2015

The challenges that plagued the healthcare industry this year won’t evaporate come January, but the presidential election may usher in a new set of challenges – and perhaps opportunities, according to EmCare's chief medical officer.

Top Challenges for Hospitals

If a Democrat gains control of the White House in November, not much will change for the healthcare industry, according to Dighton Packard, MD, FACEP, chief medical officer of EmCare. However, if a Republican is elected president and the party wins control of both houses of Congress, there will be “significant changes but it’s impossible to predict that specifics of those changes.”

The top three challenges hospitals will face in 2016, according to Dr. Packard, are:
 

  1. Shrinking reimbursement, with rural hospitals feeling the hardest pinch.

  2. Hospital-physician alignment, which will be key in the era of value-based purchasing (VBP). Nearly 160 more hospitals will see positive VBP adjustments this year than in 2015, with 475 hospitals righting course from penalty to bonus, according to a recent Modern Healthcare analysis.

  3. While it’s projected that healthcare spending will dip in 2016, hospitals will still need to put considerable mindshare toward managing costs while improving quality.

Top Challenges for Physicians
 
  1. Despite the U.S. Senate’s repeal of the sustainable growth rate (SGR) formula, physicians are still losing money each year, according to Dr. Packard. While reimbursement is flat, he explained that physicians and facilities are pressured to improve clinical quality, which puts a larger chunk of physicians’ income at risk each year. “At best, physicians are losing income to inflation, but at worse, it may be much more significant,” said Dr. Packard.

  2. Increased regulatory hassles, including continued ACA-related insurance regulations. Dr. Packard asserts that while few states will move to expand Medicaid, expect changes in the commercial insurance market through the proliferation of high-deductible plans, the loss of balance billing and decreased or static commercial reimbursement rates.

  3. Burnout and staffing challenges will continue to impact the industry. In fact, a recent Mayo Clinic study found that burnout and satisfaction with work-life balance have worsened dramatically. Recognizing the signs of burnout and moving to non-traditional practice environments, like urgent care or telemedicine, can help mitigate the effects on clinicians.For EmCare, Dr. Packard sees many of the same challenges outlined above, but says the company will continue to do what it can to advocate for its physicians.

“We must protect the practices of our clinicians,” said Dr. Packard. “We must maintain their incomes and relieve our clinicians of government hassles. We need to find ways to make our practices more productive and professionally and personally satisfying for our clinical workforce.”

Dighton Packard

Dighton C. P
ackard, MD, FACEP, has practiced emergency medicine for more than 30 years. In addition to his duties as Chief Medical Officer for EmCare, Dr. Packard also serves as Chief Medical Officer of Envision Healthcare, the parent company of EmCare Inc. Dr. Packard serves as the chairman of the Department of Emergency Medicine at Baylor University Medical Center in Dallas, Texas, and is a member of the Board of Trustees for Baylor University Medical Center. He received his undergraduate degree from Baylor University, Waco, Texas, and his medical degree from the University of Texas Medical School at San Antonio.
 

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