At MGMA, uncertainty about the future of healthcare

A panel discussion taking place at MGMA-ACMPE’s annual conference in San Antonio Monday morning focused on the state of healthcare, with an eye toward the future.

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Topics ranged from the upcoming election’s impact on the Affordable Care Act and healthcare reform to overutilization, but the most intense response came during discussion of the predicted doctor shortage and the practicalities of compensating for it.

While it may be difficult to accept, said Rich Umbdenstock, president and CEO of the American Hospital Association, “We’re not going to get the numbers of physicians, or frankly, even nurses, that we’re going to need.”

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Noting that physician shortage predictions in the past came to naught, Jeremy Lazarus, MD, president of the American Medical Association, said that how severely the workforce may be impacted is hard to judge because it isn’t known how models such as accountable care organizations and other team-based care models will affect workforce needs. No matter how things develop, though, he stressed, what patients want is team-based care lead by doctors.

A ripple of disbelief swept the crowd when Carolyn Pare, president and CEO of Buyers Health Care Action Group (BHCAG), disagreed with Lazarus, saying, “Not all people I talk to say they want to talk to a doctor. As a matter of fact, a lot of people say they would prefer not to talk to a doctor.”

Pare didn’t elaborate further, but Umbdenstock added that the degree of comfort patients have with receiving care from different types of practitioners varies and the healthcare industry should be responsive to the care delivery wants of patients.

The panelists, on the whole, agreed that the future workforce – medical students – is not being taught, currently, how to deliver care in team-based models, and that changes to medical education to support such models must happen.

As part of the panel discussion, the panelists also shared which issues are important to their constituents.

Among their concerns:

  • A lack of definitive guidelines from the federal government and how to tackle quality, safety and costs – Allan Korn, MD, senior vice president, chief medical officer, Office of Clinical Affairs, Blue Cross and Blue Shield Association
  • What will happen with the exchanges and the Cadillac tax – Pare
  • How hospitals can move from the current system to one in which they take on more financial risk and accountability for quality and safety – Umbdenstock
  • The 2 percent sequestration cuts and the 27 percent sustainable growth rate (SGR) cut – Lazarus