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As the U.S. population ages and the demands for quality health care delivery
increase, the burgeoning physician shortage is all the more critical. How are
hospitals and medical groups addressing the problem in terms of staffing
approaches? This month’s survey spotlights the views of hospital administrators
and physician recruiters concerning this important matter.
Rx for the Physician Shortage
Both commercial and medical publications point out the physician shortage that has occurred in most medical specialties. Here are some of the facts and predictions: |
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- One-third of active physicians practicing in the United States are 55 years or older and likely to retire in the next decade.
- As doctors’ incomes from third-party reimbursements decrease, more practitioners are opting for early retirement.
- Rising medical malpractice premiums—sometimes seen as “exorbitant”—are driving some physicians to explore other career options.
- Although the number of U.S. medical school applicants has increased, the number of doctors entering the profession has not kept pace with the growing population and, especially, the medical needs of the 78 million Baby Boomers reaching retirement.
- It’s estimated that by 2025, the nation will need at least 70,000 more physicians than currently are practicing medicine.
Our monthly survey, “Addressing the Physician Shortage,” offers the views of hospital administrators and in-house recruiters regarding projected MD staffing needs associated with various medical specialties.
This edition’s Special Report discusses the burgeoning problem of a shortfall of physicians and suggests some remedies. Several Jackson & Coker Industry Report articles also offer practical steps for addressing the problem. “Effective Physician Recruitment” mentions recruitment tools useful in attracting physicians to rural opportunities. Our guest feature article, “Make the Most of Web-based Physician Recruitment,” highlights the benefits of a robust Internet-focused recruitment strategy for attracting more qualified candidates for permanent hire.
The physician shortage problem won’t be remedied over night. However, it’s encouraging that means are being undertaken to minimize the impact of the shortage while the medical profession seeks more substantive long-term solutions to the current staffing crisis.
Cordially,
Calvin Bruce
Managing Editor
National Health Insurance: Could it Work in the US?
Source: American Journal of Medicine
Date: 07/01/2008
As the U.S. has one of the highest standards of living, is a leader in technological innovation, and spends more on health care than any other country, its citizens have reason to expect better care than what many receive.
This gap between expectation and reality is effectively illustrated by a 2007 New York Times/CBS poll which, among other things, found that 61% who were uninsured did not obtain needed care effectively. More to the point, the mortality rate for the uninsured is higher than that for the insured. Compounding the problem is the fact that many have inadequate health care because they have inadequate insurance.
An increasing number of employers cannot afford to offer their employees health insurance, and most individuals cannot afford to purchase health insurance out-of-pocket, which can cost more than $12,000 a year for a family. In addition, the fragmentation of the private insurer system makes for enormous administrative costs—as much as 31% of all health care expenditures. As a result, the cost of insurance continues to exceed the rate of inflation.
Thanks to a lack of cost controls, Americans pay up to two times what citizens in other countries do for their prescription drugs. Cost concerns have been shown to play a large role in failure to take proper dosage or failure to renew prescriptions.
The authors of this article contend that the time has arrived for national health insurance. For those unconvinced that national health insurance could work in America, they point to Medicare, which has provided quality health care to 44 million American at a mere 1/6th the administrative cost of private insurers. They also suggest community-based premiums and fee-for-service payments. Whatever strategy is pursued, we are implored to agree that our status as the only industrialized nation that does not ensure access to health care to all its citizens must change.
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Grassroots Movement Grants Medical Home, Access to the Uninsured
Source: Managed Healthcare Executive
Date: 07/01/2008
While most physicians aren’t new to the idea of volunteerism, the grassroots movement Project Access is using the idea of volunteerism and collaboration within the medical community as a solution to the problem of quality and affordable health care for the nation’s 46.5 million uninsured.
The movement provides a network for specialists and general practitioners who volunteer their time to partner with hospitals, pharmacies, insurers and other healthcare stakeholders to provide care for uninsured Americans. This coordinated approach, funded by the Robert Johnson Wood Foundation’s Reach Out program, helps to diminish the organizational, financial and time obstacles that have contributed to the decrease of physicians providing charity care.
The program, which was launched in 1995 in Buncombe County, N.C, began by inviting the county’s 700 primary and specialty physicians to donate time to care for uninsured patients. Within the year, 70% of the county’s physicians had volunteered to help, and today 90% of the physicians in Buncombe County work with Project Access to provide nearly $12 million in medical care for the uninsured in Greater Asheville, N.C.
Strong physician support such as that demonstrated by Buncombe County’s physicians has helped Project Access attract new partners and grow into a national movement. From laboratories, to hospitals, medical equipment companies, medical homes and county commissioners, Project Access has attracted involvement from all facets of the medical community throughout the nation.
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Billing Enforcement Pilot Recovered Millions for Medicare, Feds Plan to Crack Down Nationwide
Source: HealthcareFinanceNews.com
Date: 07/15/2008
The Centers for Medicare and Medicaid Services recently reported that the federal government recovered nearly $700 million in improper Medicare payments through a recovery audit contractors (RAC) three-year pilot project in California, Florida, New York, Arizona, Massachusetts and South Carolina.
The RAC report showed that 85% of the recovered overpayments were collected from inpatient hospital providers, 6% were collected from inpatient rehabilitation facilities and 4% were collected from outpatient hospital providers. The majority of the overpayment errors were due to accidental double billing and miscoded claims.
Although the pilot program also discovered $37.5 million in underpaid claims to providers, the primary result of the RAC report is that providers will face “unprecedented pressure” and scrutiny from the nationwide RAC program that will leave many doctors unprepared.
The nationwide program may result in the forced closing of practices for doctors who haven’t been recording their care properly, but CMS officials say that the RAC program has a limited impact on most providers – the majority of hospitals in the pilot program states faced only a 2.5% impact on their bottom line.
Some critics believe that supporters of RAC have a financial incentive to find overpayments and are calling for a Government Accountability Office evaluation of the RAC program.
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E-Prescription Networks to Merge
Source: The Washington Post
Date: 07/01/2008
In an effort to increase the doctors’ usage of electronic prescription technology, RxHub, which sends prescriptions to mail-order firms and provides information about insurance coverage, and SureScripts, which routs prescriptions to pharmacies, have merged to become SureScripts-RxHub.
As a result of the merger, the two electronic prescription networks hope to simplify the electronic prescription process in an integrated network that connects doctors, pharmacies and benefit payers. SureScripts-RxHub plans to use this network to raise the percentage of prescriptions submitted electronically from its current proportion of 2% of 1.5 billion annual prescriptions. Additionally, Sure-Scripts-RxHub claims that electronic prescriptions will help to avoid handwriting errors and decrease the 7,000 patients who die and 1.5 million patients who are injured from prescription errors each year.
Analysts hope that the e-prescription network will contribute to the creation of a national electronic health records system in the nation. The timing of the SureScripts-RxHub network coincides with governmental actions to remove barriers to the adoption of e-prescribing and electronic health records, such as weak incentives to purchase equipment, legal difficulties and privacy concerns.
The proposed Congressional legislation would offer financial benefits to doctors who buy e-prescription technology. Additionally, the Drug Enforcement Agency’s proposed removal of the ban on e-prescribing some controlled substances would contribute to the speedier adoption of e-prescription technology.
However, the medical community has raised concerns regarding the adoption of e-prescription technology. The American Medical Association has stated that public health insurance doesn’t cover the cost of basic health care, let alone high-tech e-prescription services. Privacy concerns regarding the transfer of patient data between company computers also exist.
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PhRMA Announces Revised Code Guiding Industry Interactions With Physicians
Source: American Academy Of Family Physicians
Date: 07/10/2008
In an effort to guide “the interactions between company representatives and health care professionals,” PhRMA, the Pharmaceutical Research and Manufacturers of America, strengthened its marketing code for pharmaceutical research companies’ interactions with physicians.
The revised “PhRMA Code on Interactions with Healthcare Professionals” is intended to re-focus pharmaceutical and biotechnology companies’ relationship with healthcare professionals as a relationship solely for the provision of scientific and educational information and support for medical research.
In order to meet this objective, the new code restricts the types of gifts and meals offered to physicians and their staff by the pharmaceutical industry to educational gifts and meals that are part of informational presentations. Meals may not be provided directly to participants at CME events.
The new code also provides stricter standards regarding the nature of pharmaceutical industry interactions with health care professionals who are commercial consultants or members of the pharmaceutical companies’ speakers’ bureaus. Companies’ monetary and meal payments to health care professions must be “reasonable” and all relationships between health care professionals and pharmaceuticals must be fully disclosed.
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