Someday I hope to have an Electronic Health Records (EHR) system I can believe in -- one that helps me practice medicine better. When doctors express dissatisfaction with the software they use, it's not because of an aversion to technology or resistance to change. Medicine has been on the cutting edge of technology for years. There are journals full of ongoing research that regularly change the way we care for patients. I treat many conditions differently now than I did when I graduated from medical school 15 years ago. We now use robots, lasers, and endoscopes in surgery.
People in much of Minnesota, northwestern Pennsylvania and Tucson, Ariz., are getting the best bargains from the health care law's new insurance marketplaces: premiums half the price or less than what insurers in the country's most expensive places are charging. The 10 regions with the lowest premiums in the nation also include Salt Lake City, all of Hawaii and eastern Tennessee. This ranking is based on the lowest cost of a "silver" plan, the mid-range plan most consumers are choosing. The cheapest cost regions tend to have robust competition between hospitals and doctors, allowing insurers to wangle lower rates. Many doctors work on salary in these regions rather than being paid by procedure, weakening the financial incentive to perform more procedures.
American physicians, worried about changes in the health care market, are streaming into salaried jobs with hospitals. Though the shift from private practice has been most pronounced in primary care, specialists are following. Last year, 64 percent of job offers filled through Merritt Hawkins, one of the nation's leading physician placement firms, involved hospital employment, compared with only 11 percent in 2004. The firm anticipates a rise to 75 percent in the next two years. Today, about 60 percent of family doctors and pediatricians, 50 percent of surgeons and 25 percent of surgical subspecialists — such as ophthalmologists and ear, nose and throat surgeons — are employees rather than independent, according to the American Medical Association. "We're seeing it changing fast," said Mark E. Smith, president of Merritt Hawkins.
A leading credit rating agency is panning two proposed changes to ObamaCare's implementation as negative for health insurance companies. Moody's Investors Service said Thursday that requiring insures to expand their provider networks and allowing patients to keep non-compliant health plans for an additional two years could harm insurers and raise prices on the exchanges. The firm also characterized this week's second, partial delay of the employer mandate as frustrating and logistically complicated for the insurance industry. "Insurers have already begun to develop and sell small group compliant policies to employers," stated a credit outlook report released Thursday.
One in five people who signed up for health insurance under the new health care law failed to pay their premiums on time and therefore did not receive coverage in January, insurance companies and industry experts say. Paying the first month's premium is the final step in completing an enrollment. Under federal rules, people must pay the initial premium to have coverage take effect. In view of the chaotic debut of the federal marketplace and many state exchanges, the White House urged insurers to give people more time, and many agreed to do so. But, insurers said, some people missed even the extended deadlines.
More than three months after ObamaCare's launch, the Centers for Medicare and Medicaid Services (CMS) is developing a system to track enrollees who have made premium payments. The CMS would be able to track premium payments through the "834 form" generated on the back end of the system and transmitted from HealthCare.gov to the insurers when someone selects a plan online. A CMS official told The Hill some issuers were already providing these "effectuated 834 transaction forms," which will eventually be "the mechanism for making payment and reporting enrollment data as part of our automated system."