If you sat down and talked to a physician 20 years ago about the field of medicine, he or she would have proudly discussed the opportunities and rewards of the profession. Today, that same physician might also tick off a list of challenges or caution others about the pressures and regulatory complexity of the job. Recently, David Henriksen, McKesson’s senior vice president/general manager of Physician Practice Solutions (PPS), answered questions about about how physicians are managing in the current climate of healthcare reform.
Q: Describe what the current climate is like for physicians.
A: I’ve worked in the healthcare industry for more than a decade, and there is no way to sugar-coat the pressures that physicians are facing now and in the near future. The single biggest challenge is reimbursement resulting from major cuts in the Medicare fee schedule, which in turn affects commercial fees.
Healthcare reform is a subset of the reimbursement issue. Reform is shifting risk away from the payer and toward the physician provider. Instead of fee-for-service reimbursement regardless of outcome, physicians will be reimbursed by measuring their ability to manage outcomes—whether that be wellness, chronic disease, or acute illness.
Q: What other challenges do physicians face?
A: The second biggest challenge is government regulations such as ICD-10, meaningful use and e-prescribing penalties. In order to practice medicine, our physician customers feel they have to deal with more and more red tape.
Thirdly, physicians are concerned by growth in patient volume. It is estimated that over 30 million new patients will enter the healthcare system in the next year and a half, yet recent reports say physicians are burning out and are dropping out of medicine.
Finally, while many physicians are embracing information technology (IT), they feel that it is being thrust upon them without adequate reward for their associated efforts. Yes, there are incentives for using IT today, but physicians know the penalties are quickly approaching. When you add all of these challenges together, it’s not surprising that physicians feel they are carrying a huge burden.
Q: So what’s a physician to do?
A: Here is the other side of the coin. The programs that are now in place and the trends we see—from healthcare reform and new reimbursement models to the accountable care movement and the medical home initiative—bring a great opportunity to empower physicians to take a lead in transforming healthcare.
As physicians assume greater risk, they also have a greater opportunity to increase reimbursement for their services. Physicians will again have the platform to manage and direct the healthcare system as a whole and will be suitably prepared to take on more automation and volume.
Q: So physicians seem to be gaining some power?
A: Both payers and health systems understand the value of the physician in the new paradigm, and both are scrambling to win physician loyalty. There is a constant debate in healthcare about how long this will take, and what the future state will be for office-based physicians. The opportunity is right now, and there has never been a better time for physicians to take advantage of these trends. The evolution in healthcare is coming, the sooner the better for physicians.
Q: How do you see technology helping physicians? In other words, what are you and McKesson doing for them?
A: We’ve got solutions to help physicians manage everything from patient wellness to electronic health records to reimbursements. A key thing is making sure we provide answers from across our whole company. We know we will have greater success and our customers be better positioned to succeed by doing so. McKesson Practice Care™ is a prime example of a collaborative solution to meet the evolving needs of today’s primary care physician. Through McKesson Practice Care, we provide patient-centered medical home transformation support and other solutions that position the practice to participate in future healthcare models and incentive programs.
David Henriksen holds responsibility for overseeing McKesson’s practice management and electronic health record solutions for physician practices. He joined the Physician Practice Solutions group of McKesson in 2006.