Doctors are expected to leave private practices for hospitals at an increased rate over the next 18 months. Technology mandates and increasing costs of maintaining a private practice are the main issues which are causing doctors to transition to hospital settings, according to an Accenture report.
Subscription-based care is expected to become a more prevalent option for doctors who wish to remain in private practice with Accenture estimating that one in three doctors wish to transition to that model. The percentage of independent physicians is expected to fall to 36% by the end of 2013, down from 57% in 2000. More than half (53%) of doctors who left private practices identified electronic medical record (EMR) requirements as a major reason for doing so.
Implementing and maintaining an electronic health record (EHR) system requires work from a health information manager to properly report use of EHRs in order to receive meaningful use incentive payments. Proper coding has proven difficult, with some facilities guilty of “upcoding” in order to receive greater incentive payments. Other facilities might intentionally “downcode” in order to avoid mistakes or to stay off the regulatory radar of the Centers for Medicare & Medicaid Services (CMS). This outlines the difficulties that doctors can have with EHR requirements, which have driven them away from private practices.
EHR training, maintenance, and infrastructure have been documented as being far more costly than implementation in the overall EHR budget. A five-physician practice can expect EHR implementation costs of over $160,000 and more than half of that — $85,000 — will be spent on first-year maintenance, as noted in a study of 26 primary care physician offices in Texas. The expected maintenance fees are nearly twice what an eligible provider can receive in incentive payments; however that shouldn’t necessarily discourage providers from EHR adoption. IT supplier CDW conducted a study that noted proper use of EHRs could result in an additional $150,000 per physician every year.
A successful transition and use of EHR systems can be achieved through establishment of a long-term plan at the outset of implementation. Regular maintenance fees are often overlooked, with providers focusing on initial licensing and technology costs. Transferring paper records to electronic files and yearly hardware replacement are other costs often underestimated prior to EHR implementations. Educating staff about EHRs and its goals is a recommended practice for achieving best use of EHR technology.