BOOK
Health Care Reform and Gastroenterology, An Issue of Gastrointestinal Endoscopy Clinics - E-Book
(2012)
Additional Information
Book Details
Abstract
As the National Quality Advisor and Chair of the AGAI Clinical Practice and Quality Management Committee, Dr. Allen, along with Dr. Delegge, have created a very insightful list of topics to educate gastroenterologists about how to adapt to health care reform. The issue addresses the impact in both private practices and academic medical centers. Specific issues discussed include Gastroenterologists and Accountable Care Organizations; Health Information Technology and the Gastroenterologist; Transitioning from Fellowship to Practice 2012; Going Big in Private Practice; Clinical Service Line Management; The Impact of Health Reform on GI Reimbursement; The Impact of Health Care Reform on Innovation and New Technology; Industry and Gastroenterology: A New World; and Demonstrating Value: Registries and Beyond.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Gastrointestinal Endoscopy Clinics of North America | i | ||
| Copyright Page | ii | ||
| Table of Contents | v | ||
| Contributors | iii | ||
| Foreword | ix | ||
| Preface | xi | ||
| Chapter 1. Health Care Reform: 2012 Update | 1 | ||
| EXPANDED HEALTH INSURANCE COVERAGE | 2 | ||
| CHANGING INCENTIVES | 3 | ||
| IMPROVING INFORMATION | 8 | ||
| WHAT COMES NEXT? | 9 | ||
| REFERENCES | 11 | ||
| Chapter 2. Impact of Health Care Reform on the Independent GI Practice | 15 | ||
| CURRENT STATE OF GASTROENTEROLOGY PRACTICE | 16 | ||
| THE AFFORDABLE CARE ACT: GENERAL OBSERVATIONS | 17 | ||
| THREE MAJOR TRENDS AND THEIR IMPACT ON THE INDEPENDENT GI PRACTICE | 18 | ||
| TRANSFORMATION OF THE INDEPENDENT GI PRACTICE MODEL | 22 | ||
| REFERENCES | 25 | ||
| Chapter 3. Impact of Health Care Reform on Academic Medical Centers | 29 | ||
| EXPANDED ELIGIBILITY FOR MEDICAID | 30 | ||
| REDUCTIONS IN DISPROPORTIONATE SHARE HOSPITAL PAYMENT | 30 | ||
| IMPACT OF THE PPACA ON FACULTY PRACTICE PLANS | 31 | ||
| UNDOCUMENTED IMMIGRANTS AND THE REMAINING UNINSURED | 31 | ||
| IMPLICATIONS FOR GRADUATE AND UNDERGRADUATE MEDICAL EDUCATION | 32 | ||
| THE PPACA AND THE HEALTH CARE DELIVERY SYSTEM | 33 | ||
| POTENTIAL IMPACT OF ACOs ON SUBSPECIALISTS IN AMCs | 35 | ||
| SUMMARY | 35 | ||
| REFERENCES | 36 | ||
| Chapter 4. Gastroenterologists and Accountable Care Organizations | 39 | ||
| WHY ACCOUNTABLE CARE ORGANIZATIONS? | 39 | ||
| WHAT DOES THE PATIENT PROTECTION AND AFFORDABLE CARE ACT SAY ABOUT ACOS? | 40 | ||
| OVERVIEW OF THE ACO MODEL | 41 | ||
| SPECIFIC ACCOUNTABLE CARE MODELS ALREADY IN EXISTENCE | 43 | ||
| WHAT WILL IT TAKE FOR SUCCESSFUL IMPLEMENTATION? | 44 | ||
| OPPORTUNITIES FOR SAVINGS | 45 | ||
| CHALLENGES OR POTENTIAL DOWNFALLS | 45 | ||
| SPECIFIC IMPACT ON THE PRACTICE OF GASTROENTEROLOGY | 46 | ||
| IMPLICATIONS FOR PATIENTS WITH CHRONIC GASTROINTESTINAL ILLNESS | 47 | ||
| FINAL THOUGHTS | 48 | ||
| REFERENCES | 48 | ||
| Chapter 5. Electronic Medical Records and the Gastroenterologist | 51 | ||
| MEANINGFUL USE | 51 | ||
| VISION | 51 | ||
| PRIORITIES | 52 | ||
| DEFINITION OF MU | 52 | ||
| THREE PILLARS OF MU | 52 | ||
| BENEFITS AND PENALTIES | 52 | ||
| STAGES OF MU | 53 | ||
| HIE | 53 | ||
| QUALITY MEASURES REPORTING | 54 | ||
| THE EMR AND ITS COMPONENTS | 54 | ||
| MOBILITY | 56 | ||
| QUALITY IMPROVEMENT | 58 | ||
| PUTTING IT ALL TOGETHER AROUND RISK AND VALUE | 59 | ||
| SUMMARY | 60 | ||
| REFERENCES | 60 | ||
| Chapter 6. A Letter to Fellows: Transitioning From Training into Practice in Uncertain Times | 63 | ||
| TRANSITIONING FROM FELLOWSHIP TO PRACTICE | 63 | ||
| PRACTICES AT THE 10,000-FT LEVEL | 64 | ||
| DETERMINING YOUR PRACTICE PREFERENCES | 65 | ||
| SUMMARY | 72 | ||
| REFERENCES | 72 | ||
| APPENDIX A: EXAMPLE LETTERS AND CONTACT INFORMATION | 73 | ||
| APPENDIX B: SAMPLE SPREADSHEET | 75 | ||
| Chapter 7.Medical Practice Integration: Going Big in Private Practice | 77 | ||
| REASONS TO GO BIG | 77 | ||
| PRACTICE TYPES | 78 | ||
| PERSONAL CHARACTERISTICS | 80 | ||
| TIMING | 81 | ||
| LOCATION | 82 | ||
| REGULATORY ISSUES | 82 | ||
| SUMMARY | 82 | ||
| REFERENCES | 82 | ||
| Chapter 8. Gastroenterologists and the Triple Aim: How to Become Accountable | 85 | ||
| ESSENTIAL UNDERLYING PRACTICE INFRASTRUCTURE | 86 | ||
| GOVERNANCE STRUCTURE, PARTNER COMMITMENT, AND COMPENSATION | 87 | ||
| HIT INFRASTRUCTURE | 88 | ||
| DEDICATED SPECIALISTS IN IBD | 89 | ||
| CLINICAL CARE ALGORITHMS AND CDS TOOLS | 90 | ||
| OUTCOME MEASURES | 93 | ||
| FINANCIAL ANALYSIS AND DEVELOPMENT OF TREATMENT TEAMS | 94 | ||
| SUMMARY | 94 | ||
| REFERENCES | 95 | ||
| Chapter 9. The Impact of Health Reform on Gastroenterology Reimbursement | 97 | ||
| REFERENCES | 106 | ||
| Chapter 10. The Impact of Health Care Reform on Innovation and New Technology | 109 | ||
| HEALTH CARE REFORM LEGISLATION AND INNOVATION | 111 | ||
| DEVICE TAX | 113 | ||
| FDA | 113 | ||
| REIMBURSEMENT FOR NEW TECHNOLOGY | 115 | ||
| VENTURE-CAPITAL FINANCING | 117 | ||
| GI-SPECIFIC ISSUES | 118 | ||
| THE FUTURE | 118 | ||
| REFERENCES | 119 | ||
| Chapter 11. The Gastroenterologist and Industry: Changing Winds | 121 | ||
| WHAT IS THE PROBLEM? | 121 | ||
| WHAT STANCE HAVE ACADEMIC MEDICAL CENTERS TAKEN? | 122 | ||
| WHAT ABOUT CLINICIAN EDUCATION WITH INDUSTRY? | 122 | ||
| WHERE SHOULD THE CLINICIAN AND INDUSTRY MARKETING INTERSECT? | 123 | ||
| WHAT IS THE STANCE OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES? | 125 | ||
| WHAT ARE THE ISSUES FOR PROFESSIONAL MEDICAL SOCIETIES? | 127 | ||
| HOW IMPORTANT ARE INDUSTRY RELATIONSHIPS TO PROFESSIONAL MEDICAL SOCIETIES? | 128 | ||
| THE MEDICAL DEVICE INDUSTRY | 128 | ||
| WHAT IS THE SUNSHINE LAW? | 130 | ||
| HOW SHOULD THE PIR EVOLVE? | 131 | ||
| THE FUTURE | 133 | ||
| REFERENCES | 133 | ||
| Chapter 12. Demonstrating Value: Registries and Beyond | 135 | ||
| MEETING FEDERAL REQUIREMENTS | 135 | ||
| PRIVATE PAYOR COLLABORATION | 138 | ||
| COMPARATIVE EFFECTIVENESS RESEARCH | 139 | ||
| PRODUCT SAFETY MONITORING | 140 | ||
| INTEGRATION WITH ELECTRONIC HEALTH RECORDS | 141 | ||
| SUMMARY | 142 | ||
| REFERENCES | 143 | ||
| Index | 147 |