The Pennsylvania Medical Society has identified some of the biggest impacts health system reform will have on physician practice. Below is a synopsis of those issues. Read our full analysis. (Requires Adobe Acrobat Reader)
| 1. Medical liability grants to states and liability protection for free clinics |
| 2. Limits on physician-owned hospitals' participation with Medicare |
| 3. Disclosure requirements to refer Medicare patients for in-office ancillary services |
| 4. Administrative simplification through health plan uniform standards and business rules for the electronic exchange of health information |
| 5. Medicare payment changes such as primary care and general surgery bonuses, continued PQRI incentives, and extending the floor on the geographic adjustment to the work portion of the Medicare fee schedule |
| 6. Increasing Medicaid payment rates for primary care physicians |
| 7. Creation of an independent payment advisory board to propose ways to reduce costs and improve quality of care for Medicare beneficiaries |
| 8. New employer requirements, including penalties for businesses with more than 50 employees that do not offer health insurance and tax credits to small businesses who contribute to employee health insurance |
| 9. Health insurance benefit changes, including excluding over-the-counter drugs from being reimbursed through an HRA or health FSA, increasing the tax on distributions, and limiting contributions |
| 10. An excise tax on taxable medical devices and a tax of 10 percent on indoor tanning services |
| 11. Allowing Medicare accountable care organizations (ACO) to share in cost savings they achieve for the Medicare program beneficiaries |
| 12. National pilot program on payment bundling |
| 13. Comparative effectiveness research through a non-profit Patient-Centered Outcomes Research Institute |
| 14. Waste, fraud, and abuse reduction through provider screening and enhanced oversight periods for new providers and suppliers |
| 15. Medicare and Medicaid coverage of preventive services without patient cost-sharing |
| 16. Workforce training and development initiatives including increasing graduate medical education training positions, increasing scholarships and loans, and providing grants to providers in medically underserved areas |
| 17. Strengthening trauma care through a new trauma center program |
| 18. Requirements that providers, suppliers, Medicaid managed care organizations, and Medicare advantage organizations “report and return” overpayments |
| 19. Reduced Medicare payments for the technical component of imaging for subsequent procedures on consecutive body parts |
| 20. Extension of exceptions for outpatient therapy caps for Medicare services |