There are plenty of reasons to be pessimistic about the future of healthcare, and I've heard many of them this week. I have been in Denver at the MGMA annual conference, and almost every general session I attended started with a similar litany of statistics about the major problems with the U.S. healthcare system. To sum up dozens of charts and graphs in one sentence: We pay much more than anyone else in the world for healthcare, but don't get better quality as a result.
The bad economy has added salt to the system's wounds. I wrote last week about a survey showing medical group revenues dropping for the first time in years. On top of that, physicians are facing a potential 21% cut in Medicare reimbursements if Congress doesn't intervene by the end of the year, as well as Medicaid cuts in several states.
Yet, William F. Jessee, president and CEO of MGMA, told attendees during his keynote address earlier this week that despite all of the challenges, he remained optimistic about the future of healthcare. Here are a few of his reasons for optimism, and a few of mine:
1. Healthcare IT is improving. Several times during the conference, Jessee used an anecdote familiar to anyone who has been following healthcare IT and EHR adoption efforts. You can swipe a debit card almost anywhere in the world and instantly receive balance information and make a withdrawal in the local currency, he explained. But if someone was unfortunate enough to was seriously injured after being hit by a car while walking down the street in Denver, the physicians at Denver Health most likely couldn't pull the person's health information, even if his or her primary care physician was located less than a mile away.
Certainly, there is a long road ahead to EHR adoption, but a lot of progress is being made in other areas of health IT. Practices are innovating with e-prescribing, online patient visits, telemedicine, and a wide range of other technologies that improve healthcare delivery. And despite questions about meaningful use and concerns about HITECH penalties, the potential for up to $44,000 in stimulus reimbursement for implementing an EHR system should ease physicians' reservations about adoption, if only a little.
2. Administrative costs are getting attention. As I wrote earlier this week, there are several provisions in healthcare reform bills that could streamline healthcare administration and save billions. Machine-readable ID cards, electronic claims attachments, standard insurance operating rules, and other changes could reduce management headaches and cut practice overhead for a lot of doctors.
Even in the private sector, more attention is being paid to excessive administrative costs. America's Health Insurance Plans, Blue Cross and Blue Shield Association, eight health insurers, and five Ohio physician organizations will begin a pilot project next month that will look to reduce health insurance paperwork and ease physicians' administrative hassles. The project will create a one-stop Web portal in Ohio for electronic transactions, and 91% residents insured through private carriers will be part of the project.
3. Payment reform is a reality. Don't worry about the proposed 21% Medicare reimbursement cut scheduled for 2010. It won't go through. At worst, Congress will apply another Band-Aid and replace it with a 0.5% cut or something in that range. But even better, healthcare reform legislation may finally repeal the flawed Sustainable Growth Rate formula that puts physicians in this position every year.
There are other positive signs in the reform legislation: Primary care payment increases are being proposed, as are incentives for advanced medical homes and other projects that reward coordination and quality. Progress is being made outside of Washington, as well. Private payers are taking initiative with payment demonstration projects, and pay-for-performance programs are slowly moving beyond merely paying for reporting.
4. Leadership makes a difference. Today and tomorrow I'll be in Chicago with some of my HealthLeaders Media colleagues who are presenting this year's Top Leadership Teams in Healthcare awards. Winners come from a wide range of settings—from large hospitals to medical groups—but each demonstrates that the obstacles of today's healthcare system can be overcome.
There is a lot of defeatism about the healthcare environment, but providers' fates are still largely in their own hands.
Note: You can sign up to receive HealthLeaders Media PhysicianLeaders, a free weekly e-newsletter that features the top physician business headlines of the week from leading news sources.