Monday, December 22, 2008

"Care Integration"

Is this just another name for buying physician practices - even those across state lines?

I really don't think so.

Why?

Look how this is marketed:
...could allow Prairie to expand its cardiology services to Wisconsin, as well as parts of central and southern Illinois where Prairie doctors don’t currently visit or maintain offices...

...better able to thrive financially amid major changes in how the federal government and private insurers pay for health care...

“We are enhancing the future of health care for our patients and their families by working collaboratively with physicians to make the delivery of medicine more efficient and more structured around them, with their best interests being the highest priority.”

...to become more efficient...

...work more closely to improve care.

...Multiyear efforts to reduce waste as part of the care-integration plan will include “operational efficiencies in hospitals and clinics” and “better use of best practices in medicine,” according to HSHS. The plan doesn’t call for any job cuts, said Dave Urbanek, a heath system spokesman.
So what, really, is "care integration" that promises such efficiencies?

It's nothing more than the electronic medical record.

Or more specifically, an electronic medical record tied to accounts receivable software and credit checking.

Thanks to exhorbitant costs of implementing EMRs in physician practices, the Medicare requirements for billing and prescribing electronically, and the prohibitive documentation requirements mandated by CMS in the name of "quality," independent physician practices of all types will have no choice but capitulate to larger entities that have a fully integrated electronic medical record paired with collection software.

-Wes

1 comment:

Keith Sarpolis said...

Wes,

Couldn't agree with you more! If you havn't read it already, you should read Maggie Mahars discussionof the irrational exuberance surrounding EMR implementaion.

I also have recently come to learn that our friends at Medicare will be requiring that a code be attached to every visist for which a script was written telling them whether the script was sent electronically or not. Since this can be better integrated through a fully functioning EMR that will automatically code this into the billing portion, it means that those of us who don't jump on board with a fully functioning and expensive EMR will be penalized either by an eventual 2% cut or pecked to death by theincreasing complexity required by all this extra coding required at each visit. Our time is increasingly consumed by justifying what we do to get paid and now Medicare plands to add to our woes. It appears the only way out is to pay some big EMR maker to provide their latest product at extreme cost tothe provider. this is all starting to look like an another unfunded mandate by back door fiat.