Investing in IT could get easier
Health care lags behind many other industries in its use of information technology (IT) in part because of the significant capital required. However, two recent initiatives could encourage more physicians to invest in IT:
Bonuses for IT
Physicians in four regions may now qualify for an annual bonus of up to $50 per eligible patient for adopting IT systems that help manage and improve patient care within their practices. The bonuses are being awarded through the Physician Office Link program created by Bridges to Excellence, a coalition formed last year by employers such as General Electric and the United Parcel Service. Strategies that use patient registries, care management systems and electronic health records (EHRs) are among those being rewarded.
The program is currently available in Boston, New York’s Capital District, Cincinnati and Louisville. In the Boston area, the first round of awards have already been delivered, with a top award of $40,000 going to Harvard Vanguard Medical Associates.
A three-doctor medical group, Middleboro Pediatrics, also received a bonus for its use of EHRs. “We’re proof that good medical technology is not just for large medical groups,” said Neal Bornstein, MD, senior partner of the practice. “With good technology, practicing medicine according to the latest and best guidelines becomes routine; without it, it’s almost impossible. We could never go back to paper records.”
Help with EHRs
In July, the AAFP and 13 other national medical organizations, representing more than 500,000 U.S. physicians, announced the creation of the Physicians Electronic Health Record Coalition (PEHRC). The group’s mission is to help physicians, particularly those in small practices, acquire and use affordable, standards-based EHRs and other information technology.
“Our patients deserve doctors who have access to the most modern and connected electronic health record system available,” said PEHRC co-chair David C. Kibbe, MD, who also directs the AAFP’s Center for Health Information Technology. “While physicians are adopting information technology in growing numbers, there remain substantial economic and technical barriers to full-scale deployment of electronic health records, especially in small- and medium-sized medical practices.”
FP income comparisons
Average annual incomes for family physicians range from approximately $140,000 to $163,000, according to three recent surveys:
American Academy of Family Physicians - Practice Profile Survey, May 2004
Merritt Hawkins & Associates - 2004 Review of Physician Recruitment Incentives
Medical Group Management Association - 2004 Physician Compensation and Production Survey
25th percentile: $125, 907
75th percentile: $185,844
90th percentile: $234, 961
Medicare bonuses for shortage areas
Effective Jan. 1, Medicare will award bonuses equal to 5 percent of Medicare payments for professional services provided in designated physician scarcity areas (PSAs) and 10 percent for professional services provided in health professional shortage areas (HPSAs). Medicare will automatically pay these bonuses on a quarterly basis if the services are provided within designated ZIP codes. For services provided in ZIP codes that do not fall entirely within a PSA or HPSA, the physician must use either the new AR modifier or the QB or QU modifiers, respectively. To determine whether you qualify, check http://www.cms.hhs.gov/providers/bonuspayment.
Determining the physician workforce
To avoid a “significant shortage” of doctors, the United States needs to add 24,000 to 27,000 new physicians a year through 2020, according to the “Physician Workforce Policy Guidelines for the U.S. for 2000-2020,” recently prepared by the Association of American Medical Colleges and endorsed by the Council on Graduate Medical Education. The guidelines decline to set goals for the number of graduating primary care physicians needed. Instead, they argue that specialty distribution should be left to marketplace demands. Primary care groups worry that the lack of a policy goal could lead to a greater emphasis on graduating nonprimary care physicians and a more expensive health care system.
FPs seeing fewer kid patients
Children’s visits to family physicians dropped from 41.5 million in 1990 to 30.4 million in 2002 while the number of visits to pediatricians increased, according to data from the National Ambulatory Medical Care Survey. Whether the decline is due to patient choice or family physicians voluntarily limiting their scope is unclear. An AAFP task force is investigating the issue, with recommendations due in March.