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Top Issues that will affect Physicians in 2016

The American Medical Association (AMA) recently published the “Top 9 Issues that will affect physicians in 2016.”  Crucial developments will emerge in health care regulations, legislation and the health insurance market place.

Below is a brief summary of nine of the top issues, according to AMA.  In addition, we invite you to continue following along in our Compliance Insider as we discuss changes and updates in healthcare compliance happening in 2016, and we invite you to attend our Roundtable Compliance Webinar highlighting Compliance Changes and Updates for 2016.

  1. Medicare reform. Following the elimination of the sustainable growth rate (SGR) formula, the Merit-Based Incentive Payment System (MIPS) is under development.   MIPS is intended to streamline the various reporting programs for physicians, and alternative payment models (APM) will support physicians in adopting new models of care.
  2. EHR Meaningful Use program. Following the release of the Meaningful Use Stage 3 Final Rule, the medical community called on policymakers to “put physicians back in control of their practice and put patients before bureaucracy after the rule was released and will continue these efforts this year.
  3. Insurance mergers. Recently, the nation™s largest health insurers proposed mergers.  If approved these mergers reduce the competition in the health insurance market, and according to the publication this consolidation would have a damaging impact on patients and physician practices by reducing health care access, quality and affordability.”
  4. Provider networks and balance billing. As insurer networks are expected to continue narrowing, out of pocket expenses for insured patients will continue to increase.
  5. Prescription drug abuse and addiction. The last decade had an increase in opioid deaths which highlights the importance of the opioid overdose epidemic in the year ahead.  According to the publication, solutions need to be adopted this year such as prescription drug monitoring programs, evidence-based prescribing, a reduction in the stigma associated with substance use disorder, and others.
  6. Graduate medical education (GME) funding and student debt relief.  Funding for graduate medical education (GME) is in danger of being cut.
  7. Prescription drug costs. The cost of prescription drugs has soared in recent years.  The increase has made it challenging for patients to afford their necessary medications.  A task force has been launched that will develop principles to address pharmaceutical costs and support physicians and patients in local and national initiatives that will bring attention to rising prescription drug prices and help put forward solutions to make these drugs more affordable.
  8. Health data security. Threats to health data security have been increasing over the past two years. A study found that 81% of health IT executives reported cyberattacks in that time span.  Such endangerment of health data is expected to increase this year.  According to the publication, with such private information so vulnerable to attack, appropriate protections for sharing and data storage must be a focal point for health IT.
  9. Telemedicine will see more widespread use in the upcoming year.

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