Top 10 issues for physicians to watch in 2015

AMA Wire
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The year ahead promises many changes and challenges for the medical profession. From taking on regulatory burdens to improving health outcomes for patients, 10 of the top issues physicians should monitor in the year ahead encompass the broad spectrum of today’s medical practice.

The administrative load and competing regulatory programs

Studies show that one of the greatest frustrations to physicians is the time and expense they must devote to administrative and regulatory requirements, pulling time away from patient care without a direct benefit to care delivery or health outcomes.

In 2015, the AMA will intensify efforts to reduce barriers to providing high-quality care, including:

Electronic health records (EHR) and meaningful use

At the top of many physicians’ lists of things that need to change are unhelpful EHR systems and unachievable meaningful use requirements. According to data the Centers for Medicare & Medicaid Services (CMS) released in mid-December, more than 50 percent of eligible professionals will face payment penalties next year because they could not fulfill meaningful use requirements.

The AMA will continue to push for the adoption of solutions to the one-size-fits all meaningful use program, as outlined in a blueprint submitted to CMS in October.

In addition, the AMA is building on a new framework for EHR usability that it developed with an external advisory committee of practicing physicians and health IT experts, researchers and executives. The AMA is working with physicians, EHR vendors, policymakers, health care systems and researchers to drive EHR improvements that can advance the delivery of high-quality, affordable care. 

ICD-10 implementation

The AMA has advocated for end-to-end testing, which will take place between January and March and should provide insight on potential disruptions from ICD-10 implementation, currently scheduled for Oct. 1.

Given the potential that policymakers may not approve further delays, ICD-10 resources can help physician practices ensure they are prepared for implementation of the new code set.

Federal fraud and abuse programs

While preventing unscrupulous activities in the Medicare system is an appropriate goal, many physicians are being unduly taxed by the “bounty-hunter” efforts of the Medicare recovery audit contractors (RAC). In fact, more than 60 percent of RAC determinations are overturned when appealed. Meanwhile, CMS has a two-year backlog of appeals to sort through. The AMA will continue to push the agency to overhaul this program in the year ahead.

The Medicare physician payment system

Congress will need to act early this year to avoid a 21 percent pay cut scheduled to take effect April 1 under the sustainable growth rate (SGR) formula. Because Congress missed its opportunity last year to repeal the SGR formula using a bipartisan legislative framework, the AMA and physicians will continue communicating with lawmakers—including those newly elected—to make reforming the Medicare payment system a priority for the new Congress.

In addition to addressing the SGR formula, the AMA will be tackling other timely issues related to the Medicare fee schedule, including the value-based payment modifier, elimination of the global surgical period and potentially misvalued codes.

Adequate provider networks

The current trend toward very limited provider networks has necessitated physician action to ensure patients have access to the care they need. The AMA is bolstering its national- and state-level efforts to make sure health insurers are required to maintain adequate networks, provide timely information about the physicians and other providers to whom patients will have in-network access, and comply with all laws and regulations.

Prescription drug abuse and overdose

Most stakeholders now agree that the nation’s prescription drug overdose epidemic should be addressed primarily through treatment, prevention and education rather than law enforcement. But much work remains to execute solutions in local communities. The AMA will continue to lead policy development on this issue in the states and nationally, and engage physicians in practical activities to prevent prescription drug abuse and allow pain management for patients who need it.

Preventing type 2 diabetes and heart disease

As two of the nation’s most troubling diseases, these chronic conditions have been targeted for elimination before they develop in patients. Physicians can expect to see practical resources to help prevent diabetes among their at-risk patients and tools to help improve blood pressure control among hypertensive patients throughout the year ahead. Such resources have been under development with physician pilot sites and national partners in the AMA’s Improving Health Outcomes initiative.

Advances in clinical knowledge and information sharing

New medical information, treatments and technologies continue to evolve at an astounding rate. Staying on top of the latest knowledge and developments will be more important than ever this year. The JAMA Network continues to find ways of helping physicians keep up with clinical knowledge, including a new journal that will debut early this year: JAMA Oncology.

Transformation of medical education

Medical schools that are part of a special consortium of the AMA’s Accelerating Change in Medical Education initiative have been driving undergraduate medical education into the future by developing and implementing innovative ideas for medical student training. This work will continue to advance over the next year, and new schools will be adopting the best practices they are putting forward. Additionally, the initiative will be working toward changes in graduate medical education to improve physician education across the learning continuum.

Modernization of the AMA Code of Medical Ethics

The Code of Medical Ethics, the 167-year-old standard for the medical profession, has been undergoing a comprehensive update for the past six years, and 2014 was spent soliciting and reviewing physician feedback on the proposed changes. A draft to be considered for adoption will be released this year. 

Improved professional satisfaction and sustainability of practices

Physicians will have access to tools currently in beta testing that will help them address common clinical challenges so they can boost their professional satisfaction and the quality of their patient care. Part of the AMA’s Professional Satisfaction and Practice Sustainability initiative, the tools will offer proven practice solutions, such as pre-visit planning, synchronized prescription renewals and collaborative documentation.

Court rulings on critical health care issues

Given the number of court cases that have made it to the Supreme Court of the United States and state supreme courts over the last few years, physicians can expect that the nation’s courts will continue to play a crucial role in the practice of medicine. Topics of greatest importance continue to be the patient-physician relationship, medical liability and patient privacy.

An especially important case on patient safety heard by the U.S. Supreme Court several months ago should be decided early this year. The decision will determine whether state health care licensure boards will retain their authority to regulate their health care professions to shield patients from potentially unlawful practice. The Litigation Center of the AMA and State Medical Societies will continue to ensure the physician’s voice is heard in these cases.

AMA Wire® will provide timely coverage of these issues and many other important topics for physicians, residents and medical students throughout the year ahead.

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One important trend that you have not listed:<br/> <br/> The replacement of well trained Family Practice and Internal Medicine physicians by nurse practitioners and physician assistants in the Primary Care practice of medicine. CVS for example has largely unsupervised NPs practicing medicine. (I have personally spoken with the MD "managers" who are usually unaware of NP sometimes dangerous decisions. I predict this replacement will continue, not just in Urgent Care but in multiple venues though out the country. This will seem rude, but this trend will definitely "dumb down" medicine.
You have also excluded the burdensome maintenance of certification process which will drive many physicians from active clinical practice, as well as the lack of oversight by practicing clinicians in which many certification boards operate.
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