TRENDS, CHALLENGES, AND OPPORTUNITIES FOR 2017

The healthcare industry often becomes a nexus of political, financial, cultural, and socio-economics.  More so than ever, 2017 is poised to be a pivotal year.  For USPI’s physician network, each practice will inevitably face their own personal challenges, but collectively, many of the key trends for the year will have some level of impact.

 

Payment

How physicians get paid is always of importance to our physician network.  Through the years, new rules and reporting requirements have emerged, but for 2017, it may be one of the most significant changes facing the private practice physician.

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  • MACRA The CMS final rule regarding The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), now being called the Quality Payment Program (QPP), was issued in October of 2016 and took effect January 1, 2017. Although reimbursement will not be affected until 2019, new reporting processes will start in 2017.
  • Extension of Advanced Payment Models: The QPP introduces new Alternative Payment Models (APMs), extending the opportunity for providers to earn more while taking on a greater portion of risk. Some APM opportunities include:
  • Shift to Value Based Care  The ongoing transition from volume-based to value-based payment and care delivery models in healthcare has been a monumental industry-wide effort over the past few years and will continue its evolution in 2017.

Government Legislation 

In addition to MACRA/QPP, Congress also passed the ‘21st Century Cures Act’ adding two important provisions for physicians in the USPI network-see details below in first link.  And while President-elect Donald Trump has promised executive orders to immediately repeal and replace the Affordable Care Act, it is highly unlikely 2017 will be the year of conclusion.  Because of the 20 million Americans covered by this legislation, however, it is a topic of notable mention.

Site of Service Shifts/Healthcare Consumerism

How and where physicians practice has really evolved over the last decade.  Even over the last five years, advances in surgical techniques, pain control, and technology have played a leading role in the industry’s evolution, shifting many patient conditions/diagnoses and care from inpatient to outpatient site of service.  Two key changes underscoring this trend include CMS’ move to add codes for Spine procedures to the ASC list and dropping from inpatient only list, as well as their request and feedback on removal of knee replacements from the inpatient only list. See Analysis of OPPS Final Rule 

 

As we witness the emergence of the healthcare consumer, armed with data and information from the internet and  greater cost sharing at the point of service, we believe these two trends will continue to bring both challenges and opportunities.

Finding and Keeping Talent

The human resource aspect in the private practice is always challenging.  With the new payment rules and reporting requirements, renewed focus on the patient experience, and the greater need for efficient practice operations, 2017 is poised as an exciting year for finding a keeping talent.

 

 

As we witness the emergence of the healthcare consumer, armed with data and information from the internet and  greater cost sharing at the point of service, we believe these two trends will continue to bring both challenges and opportunities.

TESTIMONIALS

“Physician Strategy Group’s holistic knowledge of practice operations, keen business savvy and their attention to detail make them truly an invaluable asset and a trusted partner to our organization.”

Bradley Dick, CIO –

Resurgens Orthopaedics, Atlanta, GA