Home From The Editor Big changes: telemedicine and Medicare

Big changes: telemedicine and Medicare

May 2016

Published in the May 2016 issue of Today’s Hospitalist

Two stories in this month’s issue look at trends that will affect hospitalists in the not-too-distant future. While one is generating enthusiasm, the other is making physicians nervous.

Telemedicine has been touted as the next big thing for more than 20 years, but the technology is finally taking off. As our cover story points out, telemedicine is already helping hospitalists cover rural hospitals that are difficult to staff. The technology is also helping fill hard- to-cover shifts. For a specialty that is still so short-handed, telemedicine could be a godsend for patients and physicians alike.

That helps explain why telemedicine is getting such a good reception among hospitalists, and why the specialty will likely help spread the adoption of that technology.

As for the second development: Medicare is making changes to reimbursement that are slated to take effect in 2019. While that may seem far away, the experts in our story say it’s not too early to start preparing for what could be a sea change in physician pay.

Medicare will give physicians two ways to be reimbursed. The first, known as MIPS, will resemble fee for service, but physicians will have to report a huge amount of data to prove that they’re providing high-quality care.

Physicians may be able to choose the second reimbursement pathway, which is being called the alternative payment model. This would encompass programs like bundled payments, ACOs and outpatient medical homes.

Like telemedicine, there is potentially a huge upside to Medicare’s second reimbursement pathway. Physicians may have a chance to share some of the savings they produce through innovative programs.

While that’s good news for physicians who have wanted an opportunity for “gainsharing,” hospitalists are wondering how much control they’ll have in deciding whether they can participate in alternative payment models. And that is making some hospitalists nervous.

Edward Doyle
Editor & Publisher

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