health care Archives | Page 3 of 7

How to Thrive in the Obamacare Economy with Systems and People

by Nitin Chhoda PT, DPT | Nov 28, 2013 | Electronic Medical Records, Healthcare Practice Management, Physical Therapy Management

The primary objectives of Obamacare are to reduce expenses while making more money. The law does that through penalties, fines and taxes in the form of the Individual Mandate Tax, fines for not having healthcare insurance and reducing Medicare reimbursements.

To survive in the Obamacare economy, clinicians must become more efficient with the people and systems in their practice.

The Human Element

Practitioners will have to be more efficient in identifying, hiring and motivating the people in their practice.

Identifying the right people is critical.

Clinicians can’t afford to have people who just do the minimum for a paycheck.

Practitioners should be looking for people who go above and beyond.

If a staff member has extra time between patients, the desirable person is one who will use that time to conduct some marketing, work on a piece for the practice’s newsletter or some other task to benefit the practice.

When practitioners identify staff members who won’t expend extra effort to benefit the practice or are unwilling to change to meet the clinic’s demands, they may have to be dismissed.

Hiring new people is time consuming, but clinicians must do what’s best for their practice. One negative influence will spread. Don’t accept substandard attitudes.

Patients are paying more out-of-pocket expenses and they’re going to become even more aware of where they go for healthcare instead of simply going where their insurance company sends them.

The quality of the people in the practice will define it and make it stand out above competitors. Customer service and marketing has never been more important than in the Obamacare economy.

Automate The Systems

There are numerous systems that will increase a practice’s efficiency, increase referrals, provide marketing tools and expedite billing.

The key concept for these systems is automatic.

The patent-pending In Touch EMR provides practitioners with an automated insurance verification system, patient workflow, and a streamlined documentation system.

In Touch Biller Pro offers integrated scheduling, documentation, billing and marketing in a single product to increase productivity and revenues.

The automated software system can be integrated with the In Touch EMR and is Medicare compliant.

It can be used with PCs, Macs and Android systems, along with iPads. It offers claims scrubbing, batching and denial management for top efficiency.

Clinicians can also take advantage of automatic newsletter generators, done-for-you referral services, coaching and marketing solutions.

Available systems run the gamut, from Therapy Newsletter to Clinical Contact, all of which are specially designed to automate processes, increase efficiency and market practices effectively.

Good people with bad systems are a recipe for disaster. Good systems in the hands of the wrong people are potentially worse.

Clinicians may find that certain staff members have turned into prima donnas who don’t or won’t learn new things or are unwilling to change.

It’s critical to have the right people in the right positions, no matter what steps must be taken to accomplish that.

Clinicians must be strong leaders who inspire and motivate staff, while employing systems that streamline office and patient processes to survive in the Obamacare economy.

Obamacare – How the 40 Percent Tax on Policies Affects Patients

by Nitin Chhoda PT, DPT | Nov 26, 2013 | Electronic Medical Records, Medical Billing, Physical Therapy Billing, Physical Therapy Documentation

A wealth of new taxes appeared when the Affordable Health Care Act (Obamacare) was signed into law. The taxes affect a wide range of businesses, products and services, from tanning salons and medical devices to name brand medications.

Penalties were placed on investment income, health savings accounts, people without healthcare insurance, and “Cadillac” insurance plans.

Who Pays The Insurance Tax?

One of the penalties that generated the most concern among taxpayers is the 40 percent tax on what’s known as Cadillac insurance plans that feature low co-pays, deductibles and premiums.

Contrary to popular belief, the tax on “luxury” policies won’t be assessed against consumers.

The penalty will be levied on companies that offer the plans, but consumers will certainly experience repercussions as a result.

The tax officially takes effect on companies in 2018, but many employers are already taking steps to avoid paying the penalty. The tax affects all employer-sponsored health insurance that exceeds a value of $10,200 for individuals and $27,500 for families.

It hits any high-end gold or platinum policy that’s not purchased on the government’s Healthcare Insurance Marketplace.

Employers are assessed the tax if they provide workers with benefits considered too expensive by the authors of Obamacare.

Many employers are scrambling to rid themselves of the policies they’ve offered workers in the past and replace them with plans that increase the cost of deductibles, premiums and co-pays to employees.

Learning The Value Of A Dollar

Obamacare was written with the assumption that workers didn’t know or care about the true cost of their healthcare insurance, and that employer-provided policies encouraged overutilization of benefits and unnecessary tests.

With Obamacare, workers will know the exact cost of the policy when it’s included on their W-2s, when their deductibles increase, the cost of their co-pays double or triple at the doctor’s office, and dental/vision care is reduced or eliminated.

Obamacare is concerned with the physical health of patients. Dental and vision care aren’t considered essential.

By raising patient costs, Obamacare hopes to limit/reduce the number of visits people make to their physician as a means of reducing healthcare costs and curbing overutilization of expensive tests and services.

Trading Lower Wages For Insurance

In many instances, taxing employers that offer exceptional healthcare policies actually penalizes employees who have chosen to work for lower wages in exchange for better healthcare.

The taxes on businesses could add others to the pool of Marketplace purchasers, as employers stop offering benefits and dump workers and retirees into the Marketplace to find insurance.

Exemptions For Some

Exemptions from the tax have been negotiated for those in certain industries that include law enforcement, paramedics and first responders, and those providing out-of-hospital emergency services.

Also included in the exemptions are individuals doing longshore work, mining, construction, people in the fishing industry, forestry and agriculture (excluding food processing).

The Positive Aspects – A Mixed Bag

The other side of the Obamacare coin is that free preventative tests and screenings encourage people who already have insurance to use the services of their physicians, along with an estimated 30 million new patients who will be covered through Marketplace policies.

Medical professionals fear the influx of that many patients will seriously compromise the level of patient care and effectively reduce access to healthcare overall.

Businesses offering “Cadillac” insurance policies will shoulder the burden of Obamacare penalties on those plans.

As patients, employees will experience the trickle-down effect in the form of higher co-pays and premiums.

Many deductibles have increased to $5,000 and over, a figure that’s far more than many people will spend on healthcare in a year. Under Obamacare, the average person will now be paying for insurance with limited practical usage until they’ve already spent thousands of dollars meeting their deductible.

Obamacare Protection Plan – Action Steps for Patients, Pt. 1

by Nitin Chhoda PT, DPT | Nov 20, 2013 | Electronic Medical Records, Medical Billing, Physical Therapy Billing, Physical Therapy Documentation

The Affordable Health Care Act, known as Obamacare, is already bringing change into the lives of millions of individuals across the nation. Some view those changes in a positive light, while others are facing the potential for penalties, loss of employer-based insurance and even cuts in jobs and hours.

There are actions that individuals can take to protect themselves from the downside of Obamacare, and measures that can be implemented to reap the most benefit from the legislation.

It requires effort on the part of consumers, but the results could be well worth it.

Medicaid Eligibility Expansion

One of the initiatives under Obamacare was the expansion of Medicaid to millions of patients who previously wouldn’t have qualified, though a handful of states have refused to expand their programs.

It pays to check anyway, as some people who don’t qualify for Medicaid may still receive some type of assistance.

In states that expanded Medicaid programs, a family of four making $29,327 (per 2010 statistics) will be able to enroll.

Residents in states that already had generous income eligibility levels above that current Obamacare mandated amount could be eliminated from the program and referred to the Health Insurance Marketplace.

Low-income earners are eligible to receive financial subsidies to help offset the cost of coverage on the Marketplace.

Avoid the Individual Mandate Tax (IMT)

The IMT is a penalty imposed on those who don’t purchase insurance and collected through income taxes. People covered by an employer-based policy are in compliance and won’t be charged.

Those without insurance may be eligible for Medicaid or subsidies for purchasing coverage on the Marketplace.

Before writing a check to pay the IMT, taxpayers may want to wait and see if collection of the IMT is actually going to happen.

Obamacare empowers the Internal Revenue Service to collect the IMT by deducting it from any refund to which the taxpayer may be entitled, but they can’t take personal property.

The IMT is extremely difficult to enforce and may be changed in the future.

Over-The-Counter (OTC) Medications

Families with a Health Savings Account (HSA) or Flexible Spending Account (FSA) can pay for OTC remedies if a physician writes a prescription for them.

Those who take OTCs that include products such as Tagamet or Tylenol should ask for a prescription in anticipation of future needs.

Obamacare offers new hope for many individuals and families. For some, it may be an opportunity to receive treatment for potentially life-threatening conditions. Others aren’t as enthusiastic about Obamacare. They’re waiting and remaining vigilant to see what Obamacare has in store for them in the future.

The Obamacare Rollout – What Did We Learn?

by Nitin Chhoda PT, DPT | Nov 17, 2013 | Electronic Medical Records, Healthcare Practice Management, Physical Therapy Management

The rollout of the Healthcare Insurance Marketplace, the centerpiece of President Obama’s signature legislation, has been full of server overloads, last minute changes and the inability of people to purchase insurance made mandatory through Obamacare.

The problems appear to derive from a number of sources that came together to create a perfect storm of data disaster.

Overworked servers and networks couldn’t handle the sheer volume of data being transmitted.

The enrollment process didn’t allow for comparison shopping or registration inefficiencies at insurance companies.

Those factors combined to create bottlenecks at a data junction where insurance providers and credit checking agencies converged.

User Access

Some people tried to access the Marketplace in the hope of obtaining healthcare coverage for the first time. Others visited the site in an effort to avoid paying the penalties Obamacare levies against anyone without insurance. Both circumstances led to more traffic than the network could handle.

Comparison Shopping

American consumers seldom purchase anything without reviewing the cost and all their available options. The ability to compare prices was included and then eliminated from the Marketplace before it opened.

The site required individuals to register and provide verification of their identity before viewing plans, a process that significantly slowed the system’s servers and network.

The comparison option has since been reinstated.

Cheaper Insurance – Not

The term cheap is relative and Marketplace shoppers complained loudly about costs. Even with the availability of federal subsidies to help pay for policies, many feared future costs when the subsidies were discontinued.

An analysis conducted by the Manhattan Institute indicated that the cheapest Obamacare plans would be more expensive than the least expensive plans offered under the old system.

Additional traffic ensued when people began looking at policies in other states to compare prices.

The Institute study indicated a 99 percent cost increase for men and 62 percent for women. The Department of Health and Human Services asserted that costs would be approximately 16 percent lower than anticipated.

In some instances, the study showed increases of up to 279 percent over the old system.

Those findings have many families wondering how Obamacare is going to accomplish one of its stated goals – making healthcare insurance affordable.

Extraneous Information

Consumers complained that instead of clearly stating prices, they were forced to wade through information about what their policy would “normally cost” on the open market.

Buyers also objected to how subsidy information was displayed, saying it was confusing.

Data Conflicts

One of the complaints by buyers was the receipt of notifications by their chosen carriers that the information they received about costs and coverage were incorrect.

Some consumers received confirmation that they were covered, followed by emails indicating they “no longer” had coverage.

The rollout of the Healthcare Insurance Marketplace didn’t go as planned for Obamacare, leaving many consumers frustrated, angry and unsure whether they actually had coverage.

Changes have since been made to the site that officials hope will alleviate data bottlenecks and get the legislation back on the road to its stated goal. The rollout demonstrated the public’s growing demand for clear information and transparency before they’re willing to turn over their hard-earned money.

Is Obamacare Preventative Healthcare? Does it Make Americans Healthier?

by Nitin Chhoda PT, DPT | Nov 16, 2013 | Electronic Medical Records, Medical Billing, Physical Therapy Billing, Physical Therapy Documentation

One of the stated goals of the Affordable Health Care Act was to improve the overall health of Americans. As part of the goal, Obamacare created a National Prevention, Health Promotion and Public Health Council to manage the government’s goals and promote personal wellness.

The Council will make recommendations on how to move toward those ends and help people avoid serious health problems.

Obamacare includes a variety of provisions designed to promote a healthier lifestyle.

Many of those options may have little effect on individuals who already have serious or chronic health problems, nor do the initiatives take free will into account.

Obesity is of particular concern and has been designated as a security threat, based on a study conducted by retired military chiefs that make up the Mission Readiness group.

No Co-Pays For Preventative Services

Obamacare has created a list of government approved preventative tests and vaccines that will be available for free. They’re part of the guaranteed essential health services under Obamacare and no co-pays of any kind will be required from patients.

Free tests run the gamut, from mammograms, colonoscopies and those for STDs to immunizations and screenings for heart disease, high-blood pressure and cancer.

Counseling rounds out the array of no co-pay services provided under Obamacare. Individuals can avail themselves of consultations and advice from medical experts on diabetes, smoking, birth control and HIV, along with domestic violence, breastfeeding, depression and dietary needs.

Vaccines will prevent the spread of disease and screenings are valuable tools for identifying existing and potentially dangerous heath concerns.

Counseling provides patients with information they need to manage their health, but if individuals don’t act on the data to change detrimental habits they’ll still end up being treated for those illnesses.

No Behavior Goes Unrewarded

Obamacare approves and supports employer-based incentive programs to steer workers toward health and wellness lifestyles. Incentives can take the form of cash, funds deposited into a flexible spending account (FSA) to pay for medical expenses, or discounts on insurance costs.

Employers also have the ability under Obamacare to penalize workers that engage in behaviors deemed unhealthy, from smoking and weight gain to lack of exercise.

It’s a form of negative reinforcement that’s long been frowned upon as a method for disciplining misbehaving children, yet Obamacare gives the behavior a green light in the workplace.

Medicare Spending And Prevention Counseling

In addition to the free services accorded to others through Obamacare, Medicare recipients can work with their clinician to formulate a preventative health plan customized to their specific needs.

Plans will address current and future medical issues and condition management.

Healthy Choices When Eating Out

Fast food, restaurant cuisine and vending machines have been cited as primary sources that passively promote obesity.

Beginning in 2011, all restaurants with 20 or more locations were required to provide nutritional data and calorie counts on menus to aid people in making healthy choices.

The mandate also extends to vending machines.

Obamacare offers an array of beneficial services and is a step in the right direction, but health can’t be legislated.

Obamacare doesn’t address many of the critical issues that can lead to the development of health problems or the element of free will. Only time will tell if Obamacare has been successful in creating a nation of healthier people.

Will Obamacare Cause a Shortage of Clinicians?

by Nitin Chhoda PT, DPT | Nov 5, 2013 | Electronic Medical Records, Healthcare Practice Management, Physical Therapy Documentation, Physical Therapy Management

Under the Affordable Care Act known as Obamacare, approximately 30 million new patients will enter the healthcare system. The Association of American Medical Colleges estimates that by 2015, the U.S. will require 60,000 more doctors than it will have at that time.

The group expects the shortage to increase through 2025, as fewer individuals are motivated to pursue medicine as a career under Obamacare legislation.

The potential for a physician shortage was further noted by a Physicians Foundation poll in 2010.

Forty percent of respondents indicated they would retire early, take employment at a hospital, look for a non-clinical job or quit the profession entirely due to Obamacare.

A shortage of practitioners would mean longer waits for appointments and ERs filled with patients who couldn’t wait to see a doctor.

Medicare patients might need to locate a new clinician and travel longer distances to access healthcare.

Highlighting An Existing Problem

According to Dr. Reid Blackwelder, president of the American Academy of Family Physicians, a growing population, along with an aging population that requires more care, is the driving forces behind a physician shortage.

Obamacare is simply accelerating a problem that already exists.

More medical students are choosing to specialize where income potential is greater.

Obamacare places an emphasis on primary care doctors and makes them the lynchpin of many of its initiatives, the exact place where the largest need is and will be in the future.

To address the need, Obamacare allotted $1.5 billion to the National Health Services Corp, which provides support to healthcare professionals in areas with physician shortages. Obamacare anticipated that practitioners in rural areas would be especially impacted where patients have fewer options than those living in more densely populated areas.

ACOs and Reduced Reimbursements

Accountable Care Organizations (ACOs) created under Obamacare are teams of medical professionals that treat patients as a group for coordinated care.

Primary care physicians are the pivot points in these teams, creating an even greater need that could take practitioners away from the pool of available healthcare providers needed in underserved areas.

Much of the cost to implement and support Obamacare is being taken from Medicare funds. Obamacare reduces Medicare reimbursements, providing the potential to limit clinician access to millions of individuals.

Many practitioners have already stated that they won’t continue to see Medicare patients due to payment cuts.

New Opportunities for NPs and PAs

A clinician shortage could be partially alleviated with qualified physician assistants (PAs) and nurse practitioners (NPs). PAs and NPs can examine patients, diagnose, prescribe medication and make referrals if needed.

In many states, they’re required to work under the direct supervision of an M.D.

Some practitioners are reluctant to embrace a model that relies more heavily on PAs and NPs, or that gives expanded responsibility to nurses.

Health and Human Services Secretary, Kathleen Sebelius, said physician assistants and nurse practitioners are key elements in providing services under Obamacare, especially in rural and inner-city neighborhoods.

If physicians do carry through with their plans to exit the medical profession or seek other options, it could very well lead to a severe shortage of primary care clinicians at a time when 30 million new patients enter the system. Those circumstances could lead to less access to healthcare services rather than more.