Connecticut physicians plan to open retail health clinics

The largest group of primary care physicians in Connecticut is getting involved in one of the largest trends in health care: retail health clinics. ProHealth Physicians, a group of almost 200 physicians, has signed an agreement to open several walk-in health clinics in Price Chopper grocery stores. The first clinic was scheduled to open in mid-August in Putnam, Conn.

ProHealth’s clinics, which operate under the name Med-Access, will follow a model similar to the one used by retail clinic chains such as MinuteClinic, RediClinic and Take Care that have opened in other parts of the country. MedAccess locations will be staffed by nurse practitioners, who will charge $45 per visit to treat minor ailments.

Cheryl Lescarbeau, ProHealth’s director of clinical operations, told Business New Haven that one difference between MedAccess and the big retail chains is that the group’s physicians will visit the clinics regularly.

“Our concern is we want to make sure that the clinical leadership is there at the local level,” Lescarbeau said.

Medicare changes enrollment process for physicians

Medicare recently made changes to its physician enrollment process that have resulted in confusion and rejected applications for numerous physicians. Preliminary data provided to the AMA by Medicare suggests that as many as 50 percent to 60 percent of applications are being rejected because they are incomplete.

Under the new process, physicians enrolling in the program or making changes to their current enrollment information are now required to provide their National Provider Identifier (NPI) number. Many physicians do not yet have their NPI, as its use on electronic and other HIPAA transactions is not required until May 23, 2007, according to the Health Insurance Portability and Accountability Act. Nevertheless, physicians should be applying for NPIs now. The process can be completed online at https://nppes.cms.hhs.gov/NPPES/Welcome.do or by calling 800–465–3203 to request an application.

Also under the new process, physicians enrolling in Medicare or making changes to their information must agree to receive their Medicare payments via electronic funds transfer and must submit an Electronic Funds Transfer Authorization Agreement (CMS–588) with their application.

A copy of the current Medicare enrollment application (CMS–855) can be found at http://www.cms.hhs.gov/cmsforms/cmsforms/list.asp. In addition, Medicare has created a tip sheet (http://www.cms.hhs.gov/medicareprovidersupenroll/downloads/enrollmenttips.pdf) that explains the enrollment requirements.

FP recruitment sees an upswing

The number of employers looking to hire a family physician seems to be on the rise, according to a review of physician recruitment data from Merritt, Hawkins & Associates. The number of searches for family physicians increased from 166 searches in 2004–2005 to 257 searches in 2005–2006, a 55-percent increase. In addition, among the most highly recruited specialties, family medicine secured the No. 2 position, second only to internal medicine.

The average salary offered to family physicians was $145,000.

The review concludes that “two areas of primary care – internal medicine and family practice – are back at the forefront of physician recruiting.”

Certification, safe harbors announced for EHRs

Two recent developments might make it easier not only to select an electronic health record (EHR) system from among the many available, but also to actually get one up and running in your practice.

Some EHR systems now include a seal of approval from the Certification Commission for Healthcare Information Technology (CCHIT). The commission announced July 18 that it had identified 20 EHRs that met its requirements for functionality, interoperability and security. Two more EHRs were certified later that month. More than two dozen vendors had submitted their EHRs for CCHIT’s consideration.

“This seal of certification removes a significant barrier to widespread adoption of electronic health records,” Department of Health and Human Services (HHS) Secretary Michael Leavitt said. “It gives health care providers peace of mind to know they are purchasing a product that is functional, interoperable and will bring higher quality, safer care to patients.”

CCHIT will continue to evaluate EHRs as vendors apply for certification. The latest list of CCHIT-certified EHRs is available online at http://www.cchit.org/certified/products.htm.

The second EHR development occurred in August, when HHS announced safe harbor rules that should help hospitals and other groups donate EHR hardware, software and training to physicians. Previously, such donations would have conflicted with of two federal laws pertaining to the donation of certain health information technology and services.

“By removing barriers, these regulation changes will help physicians get these systems in place and working for patients faster,” Leavitt said.

Both the certification process and the safe harbor rules are intended to boost the percentage of physicians using full or partial EHRs in their office. That number stood at 23.9 percent in 2005, according to the latest National Ambulatory Medical Care Survey. That’s an increase of 32 percent since the same survey was done 2001, when physicians’ EHR usage stood at 18.2 percent.

Aetna goes public with physicians' payment rates

In August, Aetna took steps to make physicians’ fees more transparent to patients in several test markets: Cincinnati, Cleveland, Connecticut, Kansas City, Las Vegas, the District of Columbia, Pittsburgh and Southern Florida.

Aetna members in these markets can now access doctors’ negotiated fees for up to 30 of the most common services in their specialty by logging on to the insurer’s Web site and searching the provider directory.

The health plan says price transparency will empower consumers to make more responsible health care decisions, particularly as consumer-directed health plans and health savings accounts rise in popularity.

Following Aetna’s lead, Anthem, United Healthcare and Humana are reportedly planning similar programs.

IOM report addresses medication errors

The Institute of Medicine’s latest report in its Quality Chasm series, Preventing Medication Errors, contains recommendations for decreasing preventable adverse drug events, which it says occur at least 1.5 million times each year in the United States.

The suggestions most pertinent to family physicians include the following:

• Better communication with patients. The report advises physicians to inform patients about risks, contraindications and side effects of medications. It also recommends being more forthcoming with patients when medication errors occur and explaining the consequences.

• Increased use of technology in prescribing. The IOM advises using point-of-care references, accessed online or on a personal digital assistant. The report also recommends that all prescribers and pharmacies begin using e-prescriptions by 2010.

The complete report is available online at http://www.nap.edu/catalog/11623.html.