PRIVATE HEALTHCARE CENTRAL
October
17, 2007-- SURVEY SAYS: EMPLOYEES ARE OUR BIGGEST PRACTICE PROBLEM
-- SURVEY SAYS: MOVING TOWARD CASH PAY?
-- SICKO DEBATE WAS PREDICTABLE
-- REFER OUR NEWSLETTER TO FRIENDS OF APPA -- EDITORIAL: THE GOVERNATOR'S NEW PLAN
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SURVEY SAYS: EMPLOYEES ARE OUR BIGGEST PRACTICE PROBLEM APPA recently completed a 3 part survey of our members' practices to determine our most pressing business problems and the prevalence of cash pay services we offer. The results were both interesting and surprising. Over 50% of practices said their biggest issue was employees: finding good ones, training them and supervising them. A small number also had turnover, benefits and employment regulatory issues. Very few of us had problems in other areas: billing and coding, accounting and legal, support services, supplies, etc. Given the comments received, APPA's time and money would be best spent helping small practices with their employee issues. Therefore, APPA intends to explore ways in which we can help our members address their employee problems. More on this by the end of the year.
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SURVEY SAYS: MOVING TOWARD CASH PAY? With the U.S. Treasury Dept stating that 25- 30 million people will switch to consumer directed health plans by 2010, APPA felt it about time to survey members about their participation in Medicare, PPO plans and their readiness for a shift in who pays for their services. 50% of practices stated they are in no PPO plans. 3 practices are opted out of Medicare and 3 are nonparticipating. Many charge minor fees for office paperwork but very few offer specific cash pay services. Nonetheless, we hear than some practices are gradually charging cash for certain services. The biggest primary care group in our area now charges $50 or the max contract co-pay for after hours calls providing advice( their call volume understandably dropped). Practices are introducing monthly or yearly service fees for a variety of noncovered preventive and/or access services. Our APPA attorney, Wayne Miller of the Compliance Law Group, reports that he is fielding frequent inquiries about such service fee agreement documents. Compliance with federal and state statutes is vital. In summary, our practices are just beginning to explore cash pay services. APPA plans to present more information and legal guidance by the end of the year.
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SICKO DEBATE WAS PREDICTABLE The Sept 17th meeting on the SICKO characterization of U.S. healthcare was both interesting and disappointing. Interesting because of the vehemence of opposing views and disappointing because too few of the general public and press were in attendance. Many thanks to the APPA members who braved the drive to the PDC. However, most in attendance were staunch supporters of opposing views. There was one Sheila Kuehl acolyte who seemed very intelligent but absolutely believes that all federal, state and private funds should be turned over to the state and all healthcare administration and policy should be made by state beaurocracy. One of the speakers was an Ann Rynd libertarian who was in your face with the opposite view. Another speaker, also very well informed, said he had all the data to prove that the private sector does not work for healthcare. The two movies opposing SICKO were well done. Canadians who have suffered in the Canadian Medicare system were featured and the big business of brokering care across the border in the U.S. was covered. Few who saw this would come away saying that Canada's system is as great as some of our politicians claim. Too bad that the future of such a personally important issue as our families' healthcare will be debated only in soundbites.
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REFER OUR NEWSLETTER TO FRIENDS OF APPA Do you know anyone who might benefit from hearing our point of view? If so, e-mail us or call our administrator Pam Deloney at 310-453-0169 and we will forward copies of our issues.
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EDITORIAL: THE GOVERNATOR'S NEW PLAN Governor Schwarzenegger's quest for more political credibility in his unannounced campaign for a U.S. Senate seat was dealt a blow when he could not get a bill out of the California legislature that he would sign. He has now offered yet another revised proposal, which may guarantee more than one referendum on healthcare for the November 2008 election cycle. His latest press release backs off from some of his prior proposals to tax away the state's uninsured problem. He dropped the 2% tax on doctors but left the tax on other providers. With hospitals in so much trouble, one wonders how the California Hospital Association signed off on this one. The best part of the plan is way out of the headlines. He intends to bring HSA insurance tax deductibility in line with federal regulations. Both the HSA insurance premium and the savings contribution would be pretax. The rest is mostly more expensive mandates which certainly will conform to the law of unintended consequences:
That is one man's opinion. I look forward to hearing yours. Richard Taw M.D. President APPA
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Private Healthcare Central is a publication of the American Private Physicians Association. Direct comments or questions to Pamela Deloney, administrator for APPA.
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Contact Information
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