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Thursday, September 30, 2010

New Affordable Care Act provisions take effect

The much-anticipated reform provisions known as the Patient's Bill of Rights took effect last week.  These revisions are part of the Affordable Care Act -- the health care reform law that was enacted in March 2010.

The new provisions bring many insurance industry exploitations to an end and give Americans new health benefits, including helping more children get health coverage, ending lifetime and most annual limits on care, and giving patients access to recommended preventive services like screenings, check-ups and patient counseling. The new provisions include:

  • A ban on discriminating against kids with pre-existing conditions,
  • A ban on insurance companies dropping coverage,
  • A ban on insurance companies limiting coverage,
  • A ban on insurance companies limiting choice of doctors,
  • A ban on insurance companies restricting emergency room care,
  • A guaranteed right of appeal,
  • Coverage of young adults on parent’s plan and
  • Coverage of preventive care with no cost.

 
For more on each of these provisions see The White House fact sheet.

While most Americans probably consider the provisions of the Patients Bill of Rights desirable in themselves, health care reform remains controversial, with Republicans arguing that it costs more than the nation can afford and will result in government control of health care and insurers blaming their recent premium increases on the requirements of the law. Consequently, the administration’s efforts to sell America on the benefits of the law continue, most recently in the form of President Obama’s back-yard discussions of health care reform. 

Tuesday, September 21, 2010

The Medicare payment saga continues

In 70 days, physicians' Medicare payments will drop 23.5 percent unless Congress intervenes to correct the sustainable growth rate (SGR) formula that threatens massive cuts at the start of every year. In most years, Congress temporarily reverses the cuts at the eleventh hour, but this year it took Congress until late June to pass a temporary fix -- too late to stop the cuts entirely. Medicare carriers began processing many June claims at the 21.3-percent lower rate before a 2.2-percent increase finally went into effect. (For more background on the SGR, see "Trapped in the SGR fun house.")

Recently, Family Practice Management asked online readers whether the continuing payment issues are likely to affect their Medicare participation. Of those polled, 39 percent said they were "very likely" to stop participating in Medicare, 23 percent were "somewhat likely," 32 percent were "not likely" to stop participation, and 6 percent said they do not currently participate in Medicare. The online poll was conducted between July 13 and Sept. 12.


Tuesday, September 7, 2010

Red Flags rule challenged; burden on physicians cited

The Council of Medical Specialty Societies (CMSS) announced that it filed a motion to keep the Federal Trade Commission's Red Flags rule from applying to all physicians, citing that the rule "imposes significant burden on physicians, particularly solo practitioners and those practicing in small groups." Twenty-six medical organizations  – including the AAFP – have requested to be added as plaintiffs to the CMSS motion.

According to the rule, physicians are considered "creditors" and must address the risk of identity fraud by creating and implementing identity theft prevention programs in their practices. The deadline, which has been postponed three times, is Dec. 31, 2010.

The rule was created as part of the implementation of the Fair and Accurate Credit Transactions Act of 2003.

Friday, September 3, 2010

The biggest mistakes a physician leader can make

Harvard Business School recently asked nine expert thinkers on the subject of leadership to answer one powerful question: "What is the biggest mistake a leader can make?" Although their answers were directed toward business leaders, they apply to physicians who serve in leadership positions as well.

The panel identified 10 critical mistakes:

1. Putting your own interests ahead of the best interests of the organization or institution you represent. Leadership is not about money, fame, power or glory but about responsibility to the people you work with and for. -- Bill George, Professor, Harvard Business School and former Chairman and Chief Executive Officer of Medtronic

2. Betraying trust. If you break the bond of trust with those around you, nothing else you do is going to matter. -- Evan Wittenberg, Head of Global Leadership Development, Google, Inc.

3. Being certain. If you go into a situation thinking you already know the answer, you will fail to pay attention and fail to seek input. -- Dr. Ellen Langer, Professor, Harvard University

4. Not living up to your values. Leaders who espouse values but don't deliver them are rapidly found out and turned over. -- Andrew Pettigrew, Professor, Sïad Business School, University of Oxford

5. Being overly enamored with your vision. Leaders who become single-mindedly focused on a pursuit risk turning that passion into an obsession. -- Gianpiero Petriglieri, Affiliate Professor of Organizational Behavior, INSEAD

6. Displaying personal arrogance. It creates distance, demotivates those around you and increases your chances of making mistakes. -- Carl Sloane, Professor Emeritus, Harvard Business School

7. Acting too fast. Good leaders step back from a situation, get input from their team, evaluate the facts and then take action. -- Jonathan Doochin, Leadership Institute at Harvard College

8. Giving off an attitude that it's all about the leader. Your enterprise has to be about something larger than yourself, or people won't want to give themselves to it. -- Scott Snook, Associate Professor, Harvard Business School and retired Colonel, US Army Corps of Engineers

9. Being inauthentic and inconsistent. You don't want those around you wondering which personality is going to show up today. -- Scott Snook, Associate Professor, Harvard Business School and retired Colonel, US Army Corps of Engineers

10. Not being self-reflective. Good leaders constantly review their own behavior and how it affects others. -- Daisy Wademan Dowling, Executive Director, Leadership Development at Morgan Stanley

Watch the video on the Harvard Business School web site.

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