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Healthcare Template

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by

Keira Sagner

on 22 April 2013

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Transcript of Healthcare Template

The Examination Room The ongoing “margin pressure” (revenue hit) to providers is not limited to the Affordable Care Act (ACA) legislation.

Yes:
payment rates may decrease for Medicare and Medicaid populations and providers could be penalized for avoidable readmissions

But also:
lingering unemployment may lead to more uninsured patients

increased consumerism is making people more conscious of their health care spending—on average fewer visits to the doctor

fewer individuals are projected to sign up for individual insurance than originally anticipated—$ of Added Covered Lives < -$ Medicare Payment Losses


*All of these factors are putting provider margins at risk* To Top It off…

Medicare now pays 65% of beneficiary debt (down from 70%)

But government officials are pressing for a plan to reduce beneficiary debt reimbursement to hospitals…

down to 25% over 3 years

Medicare patients often account for the largest proportion of inpatient volume for an average US hospital.

Decreasing provider revenue from Medicare mandates radical cost reduction on the part of providers.

What is the affect on physicians and hospitals of the financial pressures associated with the legislation? Payment Reform and Margin Squeeze Effects on Hospitals and Physicians Luckily physicians don’t go through medical school just to make money, but we should acknowledge their concerns about elements of the Affordable Care Act. Is 2013 the year of clarity?

More like the year of less opacity. While providers will be able to look at the success of pilot programs for Affordable Care Organizations (ACOs) and Patient Centered Medical Homes (PCMHs) to evaluate plans to participate, most providers at all levels will have continued questions:

Where do I fit into healthcare reform?

How do I connect with others to take advantage of health care reform measures?

And, of particular interest today…

Is all this new data from evidence-based care really going to help me reduce costs? Add revenue? You mean, like Electronic Health Records (EHRs)? But why is this the case? How do the financial pressures physicians and hospitals are currently faced with affect the adoption, implementation, and management of effective EHR systems?

In providing various levels of Emmi product support at the care site, how do attitudes about EHR systems and budgeting at various organizational levels affect your ability to engage providers in utilizing Emmi to engage their patient populations?
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