Skip to main content

2011 Potpourri XXXIII

By August 26, 2011Commentary

The Medical Group Management Association released its annual survey of physician compensation and group operating results.  According to the survey, most medical groups lose money on a operating basis, with only groups in the West close to break-even and groups in the Northern region having very large losses.  Abut 70% of specialties saw compensation increases in 2010, led by allergists, emergency doctors and hospitalists. Primary care specialties had about a 2.6% increase.  Most of the specialists experienced lower compensation growth in 2010 than they did in 2009.   (MGMA Release)

TransUnion, a credit reporting firm, put out a release on a survey of hospitals regarding their collection practices.   There is obviously a big difference in the likelihood of getting paid and the cost of collecting if you make patients pay at the time of service versus billing and collecting later.  Yet the vast majority of hospitals collect less than 30% of payments owed at the time of service and less than 5% of hospitals collect more than 75% of payments at the time of service.  Barriers to more point-of-service payments include difficulty determining what is owed, lack of staff training, patients who don’t know or understand that they have to pay some of the cost and patients who can’t afford to pay.  When patients don’t pay at the time of service, most hospitals lose at least 30% of the amount owed.   (TransUnion Release)

From the they-never-learn department, Australia is engaging in a huge project to create a national electronic medical record.  You know, they speak English in England too, and you might want to talk to them about their experience with this notion.  Accenture is the vendor and supposedly did an excellent job of creating a personalized single medical record for Singapore.  In general, these massive health IT projects tend to end up way behind schedule and way over budget, often with functionality that doesn’t meet the original objectives.   (Accenture Release)

Standard & Poors (yes, that Standard & Poors, that had either the guts or the audacity, depending on your point of view, to lower US government security ratings) released its current Healthcare Economic Index.  The Index is a rolling 12 month report on the per capita health care expenditures overall, and separately for commercial insurers and Medicare.  While the rolling change has decelerated over the last year, it remains high at 5.6% for June of 2011 for overall spending and 7.48% for commercial insurance, while price controlled Medicare still saw a 2.5% increase.  Hospital per capita costs rose 5.16%, while professional services were up 5.89%.  Not much good news for the people who end up paying these costs.   (S & P Index)

A June 2011 survey of 83 very large corporation from the National Business Group on Health reveals ongoing efforts to control health spending.  These companies expect health spending to rise over 7% in 2012, once again well above the rate of general inflation.  In response, over half plan to increase employee premium contributions and over a third will increase deductibles.  Over 70% will offer a consumer-directed high deductible plan, usually coupled with a health savings account and 17% will offer that as the only option.  Most of these employers offer weight management and other wellness services.  These companies also continue to take actions in response to changes in health laws coming into effect in the next few years.   (NBGH Release)

The Journal of the American Medical Association has a commentary regarding ten potential mistakes for accountable care organizations and how to avoid them.  The authors list the key problems as overestimating the ability to manage risk, overestimating the value of EHRs and their readiness to support ACOs, overestimation of data collection and reporting abilities, overestimation of ability to implement standardized care management pathways, failure to balance interests of hospitals, physicians and other providers, failure to get patients adequately involved in their health, failure to limit referral contracts to the most cost-effective specialists, failure to understand and comply with complex regulations and failure to create real integration.  The best way to avoid these mistakes, in our opinion, is to avoid ACOs.   (JAMA Commentary)

Leave a comment