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Everything independent physicians need to know about today’s healthcare landscape

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Healthcare is the main focus of presidential candidates, the media, and technology advocates. Today’s healthcare landscape can be complicated, with many elements for the independent physician to keep up with and to be in compliance with, depending on the provider’s situation. Those independent physicians who care for Medicare patients must know the latest updates from the Centers for Medicare & Medicaid Services (CMS).  Providers with younger patients need to understand the healthcare preferences of Millennials and Generation Zers. Rising healthcare costs impact all independent physicians.

Today’s healthcare landscape includes:

Campaigns for Medicare for All and other variations of one-payer healthcare plans. Presidential candidates are promoting their own versions of government-sponsored programs, ranging from an all-inclusive, expanded Medicare program, to public options that complement private insurance and the programs covered under the Affordable Care Act (ACA).

Technology advances. Telehealth and other virtual healthcare services are becoming more accepted and more commonly used as alternatives to the traditional office visit. Even CMS is “finalizing changes that would allow Medicare Advantage beneficiaries to access additional telehealth benefits, starting in plan year 2020.” In addition, the electronic health record (EHR) is advancing in capabilities, including interoperability, which is key to the physician’s ability to coordinate a patient’s care with other providers.

Adjusting to changing preferences. Speed, convenience, and available technology are the primary concerns for Millennials, particularly in regard to how they access healthcare. Independent physicians who offer the ability to communicate electronically, to access telehealth services, and to make appointments online or through an app will be more attractive to that busy age group.

Prescription drug prices are a topic of major concern. In a research study conducted by the Scripps Research Translational Institute, five years of pharmacy claims (from 2012 to 2017) were analyzed. The study included 49 brand-name drugs that had more than 100,000 total claims each. As reported by NBC News, “All but one of the drugs included in the study saw regular annual or biannual cost increases. The cost of 36 of the drugs increased over the six-year period by more than 50 percent, and the cost of 16 more than doubled. Overall, the median cost of the drugs included in the study increased 76 percent.”