By Abby S. Van Voorhees, MD,
January 02, 2014A chill is in the air.
The temperatures outdoors are low and the winds have a habit of howling; Philly just isn’t balmy this time of year. Shovels hang near the front door waiting to be used. I bet, though, that even those of you hanging out in the more temperate south share my feelings this month. It is not just the winter weather; there is a cold breeze coming out of Washington, too. We do our best this month to cover a few of the programs and changes that you’ll need to know about, like it or not.
The first piece that you will want to read about is on the Medicaid expansion. As a key component of Obamacare, this will greatly change the face of the insured in the United States. Each of our states will color the way it looks locally, but in many ways much will be the same for each of us in dermatology. Providing coverage for those who have lacked health insurance is a definite benefit, but problems with the system abound. Even before now access to specialty care has been spotty as a result of low reimbursement rates. Unfortunately as Jack Resneck says, “While the ACA will temporarily raise Medicaid payments to Medicare rates for primary care physicians, it does not increase payments for specialty care. The extremely low Medicaid payment rates in most states, combined with administrative burdens, continue to harm patient access to care.” So take a look at our piece — we’d love to hear how things in your state fare and learn of the novel solutions that some of you undertake to handle the new patient load. At my university we have always taken care of Medicaid patients despite the poor reimbursement; while the hassles are real, the patients are generally very appreciative. It certainly would help dermatology’s image if we’d all do our bit. Perhaps this could be your office’s New Year’s resolution?
The next article I want to highlight this month details the new HIPAA rules. Uncle Sam is not kidding with this one. Lack of knowledge is not going to get you out of it, and the penalties make me shiver. They range from $100-$50,000 per incident. Definitely gets my attention. And that is for one episode! At a big institution like mine, multiple episodes could make that total soar. Also be aware that it is no longer about just what is happening in your office. Now we are also responsible for our vendors and other business partners. My dad’s days of a simple handshake sealing a deal are long past. Find out what you need to do to be sure that your partners remain just that, rather than partners in crime.
Lastly, be sure to check out our Management in Practice column on office stealing. Not a pleasant topic to discuss, but one that we should not ignore either. I guess it seems so innocent to the perpetrator — just a few band-aids here and a few co-pays there; one can see how it could be quite tempting. While nothing can guarantee protection against this kind of loss, steps that can and should be taken are discussed. Your practice depends on it!
Good news, though — we also cover some more upbeat topics this month. Do check out our feature on propranolol. The care of kids with these hemangiomas has done a 180 — first monotherapy with propranolol was identified as being helpful, followed lately by an understanding of the benefits of its combination with lasers. What a difference in just a few short years! At last something to be upbeat about this January. Guess it is a good thing that it is time for my winter vacation plans to kick in. Hope you have some fun plans coming up too. We all may need that extra “pick me up” this year.
Enjoy your reading.