There are many issues facing Eye Surgeons in the United States and globally. Roundtables from the beginning and mid year 2015 show issues that industry leaders expect to face or benefit from in the coming year and the coming decade. Some of the issues addressed are positive changes and results. Some are challenges to be overcome and other issues are challenges to be avoided.
The diversity of issues faced by Eye Surgeons shows both the potential and the challenges in this industry in the coming years. The following are 10 issues brought up in these discussions that ophthalmologists will face in 2015 and 2016.
- Global Payments Stay – If you were tracking CMS’s (Centers for Medicare and Medicaid Services) decision in August of 2014 to prevent global billing and payments for surgeries, you will be glad to know that Congress overrode the policy changes.
- Global Payments Audit – According to the mid-year forum, Congress has enacted a policy enforcing audits of surgery follow up. The method of auditing surgeries was not included in the bill, so this is an issue that eye surgeons may face in the near future.
- EHR Changes – All medical professions face the constantly shifting requirements of electronic health records (EHR). Addressing legal issues and duplication of records are both continual obstacles to overcome in creating accurate, efficient and profitable EHR systems. Experts from the American Academy of Ophthalmology recommend using a registry system to integrate EHR records across all the surgical practices in the industry. This will facilitate communication between surgical centers, create a unified system of record keeping and make opportunities for research on a previously unprecedented scale.
- Technological Advancements – As technology advances and customers demand access to better systems, smaller surgical centers now afford technology like femtosecond technology for laser eye surgery. The advances in technology are both a tremendous opportunity for growth and medical innovation as well as a cost, training and maintenance issue.
- Continual Cost Innovation – From ambulatory surgical centers (ASC) to efficient record keeping, eye surgeons will need to continue to focus on keeping costs low. While ASCs have been around for years, they are still a much cheaper way to provide surgical care without the extra costs and paperwork of a hospital admission. Surgeons need to face the challenge of educating other medical professionals, Congress and bureaucracies and the general public about the innovative cost cutting measures ophthalmologists are implementing across the industry.
- Increased Demand for Quality – Whether it is from Medicaid or the general public, there is a demand for quality systems in the medical industry in general. This is an issue and an opportunity for eye surgeons because quality systems promote data management and research, generally cut costs from liability and poor workmanship and increase customer confidence. The quality control demands from CMS have mixed results from eye surgeries. Some codes will have to reduce their prices while others will see an increase in Medicaid reimbursements.
- Pharmacological Drugs – One of the main issues eye surgeons face from the pharmacy industry is the legal oversight of compounding drugs. Congress enacted a law (the DQSA) after the 2012 meningitis outbreak caused by inadequate safety, quality and cleanliness controls at a compounding center. Since many of the drugs used in eye surgeries have to be compounded, the resulting regulations have limited some access to drugs as well as increased the price of available medication for surgical care and recovery. One of the legal issues the DQSA did not address is about in office compounding, although there is a specific loophole for compounding for a specific patient.
- Changing Payment Systems – The FFS (Fee for Service) system of billing and payment plans is being phased out by many in the healthcare industry. Innovation drives a marketplace of payment systems created by coordinated care organizations. Although surgical centers face issues with changing business plans and payment processing, there is tremendous opportunity to provide valuable services in coordinated care organizations and increase income at the same time.
- Continued Diligence in Paperwork – Throughout all the issues addressed at these two roundtables, a common theme is the issues facing eye surgeons because of legal paperwork. There are many quality reporting controls that increase labor costs to a surgical center but do not increase patient care or surgical efficiency. There are also many changes throughout the medical system because of safety laws, regulatory changes to Medicaid and Medicare. The Affordable Care Act also greatly affects the medical industry, eye surgeons included.
- Increasing Scientific Literature – Since scientific documentation and data is doubling every 15 years, it is not possible for an eye surgeon to learn all there is to know. Many surgical businesses, associations and advocacy groups are arguing for marketplace quality systems to achieve the results the US Government is attempting to create through MU, PQRS and more. Data management systems and streamlined business processes are part of the recommended tools necessary to increase quality while not significantly increasing the already overbearing workload.
These are some of the issues that eye surgery clinics and ASCs will be facing in the years to come. Although there are many different issues ophthalmologists face, there is tremendous opportunity for growth through innovative business systems and medical technology.
For more information about how to address these upcoming issues and increase your quality care and paperwork with as little cost as possible, contact AdvantageAdministration, Inc. today.