Predictions for 2012 and Beyond

By Dave Jakielo, CHBME

My business of speaking and consulting usually has me on an airplane at least every other week. The downside is the unpredictability of airline schedules; it seems that a flight's posted departure time is just a suggestion – not a commitment from the airlines.

While travel is sometimes a hassle, it also has an upside. The hours spent either waiting for a flight or actually flying can be put to good use, and it allows me the time to read or listen to books, magazines, podcasts, etc.

Today, information is so readily available that staying current with what is happening in all facets of healthcare is much easier than it was only a few years ago. Additionally, spending time in company offices and talking with people at every level of an organization gives me further insights into what is occurring in a particular region. As we all know, healthcare is regional.

My extensive reading and first-hand experiences with what has been taking place in healthcare this past year have led me to make my predictions for 2012. My thoughts are based on trends that are already occurring somewhere in the nation and that may be coming to a neighborhood close to you, too.

PHYSICIANS: There will be fewer and fewer physicians in solo practices in 2012 due to rising costs and the fact that doctors coming out of medical school cannot obtain money from financial institutions to start up new practices.

More doctors will either merge with other practices or become employees of hospitals. Again, the unpredictability of what looms in the healthcare reimbursement arena has many physicians concerned about the future and feeling that a guaranteed salary is a safer bet. Plus, many would rather adopt another practice's EHR than go through the process of implementing one from scratch in their current practice.

FEE FOR SERVICE:  Medicine has become a business that is a pure numbers game. We currently have around 40 million people on the Medicare rolls and within the next 15 years that number will explode to 100 million. Given the increase, another method of paying for services will have to come into existence. The, "The more you do, the more you make," model is not sustainable.

Even if Accountable Care Organizations (ACOs) do not become prevalent, some bundled payment system will have to come into play. Another option is that hospital-based physicians could become salaried once again, like in the 1980s, and Part B billing for them would simply go away.

PRACTICE MANAGEMENT SOFTWARE COMPANIES BECOME COMPETITORS: There are already over a half-dozen software vendors who have purchased or started up billing companies, and this trend will continue. Why this is occurring is simple: they are attracted to the recurring revenue stream of medical billing revenue versus relying on the, "I must continue to sell, sell, sell a product!" revenue model.

Given this trend, it is imperative that you check your software agreement with your practice management software provider. Ensure that it contains a clause stating that they cannot offer billing services to one of your current clients for up to 24 months in the event that said client would leave your company. If your agreement doesn't contain this, try to add it as an addendum.

NON-MEDICARE SERVICES WILL DECLINE: As healthcare premiums continue to rise by double digits every year, personal deductibles will continue to escalate. Many deductibles today are already $5,000 or higher, thereby causing people to think twice before seeking medical care. The annual physical is becoming the every two or three years physical. Rather than running to the doctor with every ache and pain, we now give our minor problems a day or two to see if they go away on their own.

Non-Medicare patients are more likely to seek medical care at the new clinics that are popping up like weeds in chain pharmacies, retail stores, and other consumer locations. Patients figure that if they have to pay for services anyway, they will go to a place where it's convenient and timely instead of calling their doctor and waiting days for an appointment.

So, summarized above are some of my predictions for 2012. While you may consider them to be threats, others embrace the facts and look at the future as a huge opportunity to dramatically grow their businesses.

Remember, the choice is yours: you can be fearful of the future and slowly fade away, or you can embrace the future and become a bigger and stronger company.

Dave Jakielo, CHBME, is an International Speaker, Consultant, Executive Coach, and Author, and is President of Seminars & Consulting. Dave is past President of Healthcare Billing and Management Association and the National Speakers Association Pittsburgh Chapter.