?Healthcare: Health Care Industry Faces Various Risks
Whether you work directly with patients or oversee the operations of a hospital, you know the health care industry is changing rapidly. Gaps in primary care, electronic health records and health privacy are all valid concerns. There are also may health care risks facing clinical professionals and hospital executives. Here is what you need to know about these risks.
One of the greatest risks in the health care industry is the planned transition to the ICD-10 system. Industry experts expect reimbursement levels to decline after ICD-10 is fully implemented, causing some executives to worry about cash flow and projected revenues. If you are concerned about the transition, take time to train coders and physicians on using the new classification system. Work with your chief financial officer or budget manager to improve your revenue cycle in advance of the change.
Electronic health records are both a blessing and a curse for the health care industry. EHRs make it easier to share health information with other facilities, preventing adverse events and improving patient outcomes. Unfortunately, the use of EHRs makes medical facilities a target for hackers. As a result, companies in the health care industry must spend more money on IT security and electronic monitoring systems.
Physician contracting is another hot issue in the health care industry. Executives must comply with the Stark law, which governs physician referrals and reimbursements for patients receiving coverage via Medicare or Medicaid. Physician contracting regulations have become increasingly complex, especially if physicians travel between two or more clinical sites. As a rule, your facility should have an attorney or committee review every physician contract to ensure you offer a competitive compensation package based on specialty and location.
When the federal government started requiring the use of EHRs, companies in the health care industry had to start complying with meaningful use rules. There are three stages of meaningful use: data capture and sharing, advanced clinical processes and improved outcomes. Health care facilities had to be in compliance with the first two stages by the end of 2014. The government expects health care organizations to be in compliance with the third stage by the end of 2016. Meaningful use is one of the biggest health care risks because the federal government plans to reduce reimbursement rates for facilities that do not comply with the rules.
The health care industry also has to worry about quality process improvement in 2015 and beyond. Insurance companies don't want to pay for poor outcomes, so clinical professionals and executives must work together to identify best practices. After establishing best practices, health care facilities must create new policies and monitor patient outcomes to ensure those practices produce desired results.
These are just some of the hot-button issues currently shaping the future of the health care industry. If you aren't sure how to handle some of these issues, ask your legal representative for advice, or convene a committee made up of executives and experienced clinical professionals.
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