“In this press release, the American Medical Association (AMA) adopts guidelines for physicians considering employment with large institutions. AMA Guidelines are available here.

In addition to the ethical issues described, California has strict legal requirements for physicians considering a job and leaving their private practices such as:

1. Informing clients of the move
2. How to handle medical records
3. How to handle accounts receivables
4. What insurance to carry…”

To read the rest of the article, please click here.

“When reviewing the various new regulations concerning the Accountable Care Act and particularly Accountable Care Organizations, it is clear that the Primary Care Physician will be at the center of doctoring over the next several years. While there already is a shortage of good primary doctors, the shortage is about to get worse.

Here’s an article from Medscape Today:

ACA Will Require 3% More Primary Care Physicians by 2025

Robert Lowes

Nov 12, 2012

The Affordable Care Act (ACA), experts predict, will only deepen a shortage of primary care physicians brought on by a growing — and aging — population.

But to what extent? A new studyin the Annals of Family Medicine offers a hard number. It will take an extra 8000 primary care physicians in 2025 just to treat patients who obtain insurance coverage under the law, according to lead author Stephen Petterson, PhD, and coauthors.

In all, they write, the nation will need 52,000 more primary care physicians in 2025 than it has now, a figure resembling estimates in other recent studies. Before Congress enacted the ACA in 2010, the Association of American Medical Colleges had forecast a shortfall of 46,000 primary care physicians by 2025.

In the Annals of Family Medicine study, sheer population growth accounts for 33,000 of the 52,000 extra physicians needed in 2025, according to Dr. Petterson, the research director of the Robert Graham Center for Policy Studies in Family Medicine and Primary Care, affiliated with the American Academy of Family Physicians, and colleagues. Another 10,000 physicians of the total reflect the higher level of services used by baby boomers on the rolls of Medicare.

The ACA will extend insurance to roughly 30 million more Americans through 2019. The 8000 primary care physicians required by this expansion represent a 3% increase of the current workforce.

As a baseline for their projection, Dr. Petterson and co authors used the 246,090 primary care physicians who were engaged in direct patient care in 2010 as reported by the American Medical Association. They whittled down that number to almost 209,000 after excluding physicians who were retired, working as hospitalists, or working in emergency departments and urgent-care centers…”

To read the rest of this article, please visit our blog www.CaliforniaHealthcareLaw.com by clicking here.

There are several types of Accountable Care Organizations that a physician may be asked to sign a contract with, including the Medicare Shared Saving Program ACO, Pioneer ACO, and private insurance providers.

All ACO’s have certain attributes in common, including risk participation and assessment, patient participation, integrated care, evidence based care, utilization of non physician professionals (physician assistants, nursing assistants, etc.) data analysis and use of technology for improving communications and care.

As a physician entering into any contract, but particularly a contract for an ACO, you should make sure you understand the contract. In most cases, if it’s not in the contract, it doesn’t exist. If you are promised some benefit from an ACO plan, like help with achieving meaningful use (technology), make sure it’s spelled out in the contract.

Here are some other things you should review In the contract:

1. Risk Participation: Shared Savings is a concept that has not been completely defined. Providers should understand how the billing works, and how the shared savings works. Some plans have penalties for physicians who do not meet benchmarks. This is an important part of the contract. Your payment should be clearly spelled out.

2. Exclusivity: Most plans require primary care physicians (including internists, general practitioners, family doctors, and geriatric doctors)to be exclusive with the ACO. Specialist can usually contract with several. Again, this should be clearly designated.

3. Corrective Action: What corrective action will take place if a physician does not meet benchmarks?

4. Benefits Provided: ACO’s need to provide infrastructure to help achieve cost savings. These include integrated care, behavior counseling, nurse phone availability, and improved technology. These benefits should be spelled out in the contract…

To read more, please click here.

To contact Matthew L. Kinley, please click here.

Tredway Lumsdaine & Doyle LLP (TLD) is excited to announce a new resource for healthcare professionals.   TLD’s new blog is the legal source for the practice of medicine in California.  Please let us know if there are any specific topics that you would like to see covered.  You can also subscribe to the blog to receive updates via e-mail.

Click here to visit our blog:
www.CaliforniaHealthcareLaw.com

 To learn more about this seminar, please click here.