Independent physicians guide to 2020

Many of the changes that independent physicians can anticipate in 2020 are continuations of policy, regulations, and other challenges faced by both doctors and their patients over the past several years. Healthcare costs will continue to be a concern as will reimbursement and billing policies. A few newer issues of concern in 2020 include the shortage of quality healthcare workers and the patient’s increasing desire to have healthcare provided more conveniently, through the use of technology when possible.

Healthcare costs

Healthcare costs are a concern for patients and physicians every year. In 2020, however, patients will increasingly expect price transparency and about three-fourths of them will look up procedure costs online so they can be better informed about what to expect. Legislation is also being considered that would eliminate “surprise” billing so patients are not alarmed when they receive a bill after treatment. Education is key to help patients better understand and prepare for the costs of their care.

Prescription drug prices are also a major topic for 2020. Several major drug makers increased their list prices on 50 prices at the beginning of 2020. While the Lower Drug Costs Now Act passed through the House of Representatives, its survival in the Senate is seen as doubtful. Independent physicians need to be aware that their patients will be increasingly concerned about drug prices in 2020 and may need assistance with managing their prescriptions.

Value-based payments

For independent physicians who see Medicare patients, there are some changes for 2020. The Medicare Physician Fee Schedule conversion factor increases slightly, from $36.04 to $36.09. This will probably be the last significant increase in the conversion factor as there will be no inflation update in the next six years.

Independent physicians participating in Merit-based Incentive Payment System (MIPS) will face escalating penalties, particularly those who do not report any quality measures in 2020. It will be very important for independent physicians to focus on that quality reporting in 2020 so they can avoid the negative payment adjustment in 2022.

The value-based care movement has impacted payments from many private payers as well, as they see the value in paying for the quality of healthcare outcomes rather than for the quantity of office visits. Experts predict this will be a growing trend in 2020 and beyond.

 Learn more about how physicians can use the data in their electronic health records (EHRs)
to maximize reimbursement and to help patients stay healthy.

 Staffing

One of the challenges that independent physicians may face in 2020 is a shortage of qualified clinical staff. Healthcare professionals, such as nurses, are growing older and retiring and there are fewer younger people filling their positions. One estimate is that the US will need approximately one million more nurses in 2020. According to The American Nurses Association (ANA), there will be more registered nurse jobs available through 2022 than any other profession in the United States.

Convenience of care

Patients are increasingly looking for ways to save money and to use technology for their own convenience. Their healthcare is no exception. Telehealth, connecting with the independent physician via telephone or video calls, is growing in popularity, which creates challenges for the provider who operates in a traditional practice to improve access for patients.

Telehealth has also been recognized by the Centers for Medicare & Medicaid Services (CMS) as a viable alternative for seeing patients, especially younger patients and those who live in rural areas. Telehealth services are included in the 2020 Physician Fee Schedule and CMS is allowing Medicare Advantage beneficiaries to access additional telehealth benefits, starting in plan year 2020.