Reclaiming Medicine: The Locum Story of Hospitalist Dr. Brandt

In the Interim: Physicians Slam Medicare Payment Cuts; Effects of Time-based Billing on Reimbursement; Physician EHR Satisfaction; More on Burnout; Doctors on TikTok & More

“In the Interim” is a snapshot of the latest and most relevant news in the locum tenens industry. No repeats, less scrolling, more knowledge. Check out the articles we found most interesting for September’s roundup.

1. Federal Government Issues Final Rules for Surprise Billing

“Surprise billing” occurs when patients view their final medical bill and discover that they received medical services outside of their insurance coverage. In order to reduce surprise bills and improve healthcare cost transparency, the Consolidated Appropriations Act (CAA), included the No Surprises Act (NSA), officially enacted in December 2020. The NSA created federal protections that limit out-of-network health care costs and require hospitals and health centers to disclose billing information to patients.

In late August, the Departments of Labor, Health and Human Services published the Requirements Related to Surprise Billing: Final Rules.  This final set of regulations addresses payment determination standards under the Federal independent dispute resolution process and “downcoding.”

(Imaging Technology News, September 6, 2022)

2. Physicians Slam Fee Schedule Cuts, Call for Medicare Payment Reform

Centers for Medicaid Services (CMS) proposed to decrease the Fee Schedule conversion factor for 2023; this would also cut Medicare payments to physicians. The American Medical Association (AMA) advocates a reversal of these Medicare Physician Fee Schedule updates.

The AMA believes that the Fee Schedule could have a negative impact on patient care and urge policymakers to include provisions that reward physicians for delivering value-based care and advancing health equity.

(Revcycle Intelligence, September 7, 2022)

3. How Time-based Billing Impacts Physician Reimbursement

According to a JAMA study, time-based billing leads to higher physician reimbursement rates for evaluation and management (E/M) visits. By contrast, billing based on medical decision-making (MDM) leads to higher reimbursement rates for short visits.

Unfortunately, physicians often spend time reviewing medical records, coordinating care, and providing documentation; that time is not reportable under MDM-based billing and leads to hours of unreimbursed work.

Time-based billing is an alternative method that would reimburse physicians based on the length of time with a patient, and 2021 E/M guidelines allow physicians to bill for related time spent on tasks for the patient visit.

Researchers compare billing data and feel that the flexibility of time-based billing could alleviate burnout, provide better patient care, and help physicians remain involved in preventative medicine.

(Revcycle Intelligence, September 12, 2022)

4. Understanding the New World of Medical Influencing

Social media use has skyrocketed—especially with video-based content like Instagram Reels and TikTok’s platform. With COVID-19 misinformation taking a spotlight the last few years, many doctors jumped to their personal accounts to dispel misinformation and educate the public.

Many doctors amassed a great following and maintained their accounts to share their expertise and advocate for legislation. Of course, there’s a strong element of personal responsibility when publishing social media content as a qualified medical professional. At its core, “medical influencing” is authentic and accessible. These qualities can enhance the patient experience, empower clinicians to skip the red tape so often involved in patient care, and offer an outlet for physicians to express their values freely.

(Op-Med, September 13, 2022)

5. House Bill Aims to Get Rid of 2023 Medicare Cuts to Physicians

Physician groups fought against Medicare cuts, arguing that they would harm practices amid inflation and the financial fallout of the COVID-19 pandemic. Legislation led by doctors, the Supporting Medicare Providers Act of 2022, proposes to increase the conversion factor Medicare uses for physician payment calculations. The Surgical Care Coalition spoke out in favor of the legislation, claiming that it would be a critical step toward helping patients and improving care.

(Fierce Healthcare, September 14, 2022)

6. Physicians Reporting at Least One Burnout Symptom Increases 25%

The COVID-19 pandemic drastically increased levels of physician burnout, according to a recent study from the Mayo Clinic. For the last decade, researchers have consistently measured physician burnout every three years. However, after measuring burnout in 2020, there was another study in 2021 to calculate the impact of COVID-19. The 2021 results are staggering; 62.8% of physicians reported at least one symptom of burnout compared to 38.2% in 2020.

(Health Leaders, September 16, 2022)

7. Hospitals Estimate Bleak Financial Outlook for 2022

Inflation has struck every industry, including healthcare. The increased cost of staff, supplies, and drugs are all placing a huge demand on health leaders. “The Current State of Hospital Finances: Fall 2022 Update,” the latest analysis published by the American Hospital Association (AHA), covers financials for the first six months of the year.

Compared to 2019, hospitals have seen a –104% change in operating margin. The study estimates a 2022 operating margin down anywhere from 37-133% relative to pre-pandemic levels. So far, 52% of hospitals reported negative operating margins; that figure is projected to rise along with skyrocketing expenses.

(Medical Economics, September 19, 2022)

8. Physician EHR Satisfaction Varies by Specialty

According to KLAS researchers, physicians who are satisfied with their EHR are about five times more likely to remain at the hospital or health system. Unfortunately, providers often experience frustrations with functionality, ability to deliver care, and the vendor quality—sorting through these issues often adds time to their already lengthy days. The Exploring EHR Satisfaction by Provider Specialty report from the KLAS Arch Collaborative revealed that EHR experience scores tend to report consistent by specialty.

Hospitalist medicine, pediatrics, family medicine, and internal medicine reported the highest satisfaction scores. Comparatively, orthopedics and cardiologists utilizing the same EHR reported the lowest EHR satisfaction scores.

(Healthcare IT News, September 21, 2022)

That’s it for this month’s edition of In the Interim. Stay tuned for next month’s roundup of newsworthy articles for locum tenens providers. To stay in the loop on future news, follow us on LinkedIn and sign up for our monthly email newsletter for monthly news and job search tips.