Here are five predictions:
1. Telemedicine won't be futuristic anymore. More patients will want to electronically connect with their local primary care physicians, not necessarily providers across the country, to avoid traveling to in-person appointments. Telemedicine will also leverage smartphones for add-on hardware, such as biometric data.
2. Practices will restructure patient access. The Merit-based Incentive Payment System promotes patient access expansion with "practice improvement activities" like longer office hours and same-day appointments. Appointment scheduling will also shift from the office staff to the patient, so the patient feels more in control and the office is not burdened by administrative tasks.
3. Physicians will find creative financial solutions. The direct care model cuts out the payers, creating a financial relationship between patient and provider. Concierge medicine and direct primary care allow patients to become members and pay a fixed monthly fee for unlimited care.
Smaller practices may also turn to telemedicine to generate more revenue, since reimbursement is now allowed for services rendered on this platform.
4. MACRA will discourage physicians from participating in Medicare. The Medicare Access and CHIP Reauthorization Act may unintentionally force small independent practices to opt out of Medicare or not accept new Medicare patients if they fall under the exemption threshold of less than $30,000 in Part B billings or 100 Part B patients.
CMS's Final MACRA Rule offered more flexibility for smaller practices in 2017, but by 2018, there will be more financial risk and stringent reporting requirements.
5. EHRs will possess enhanced interoperability. The ONC's next certification cycle labels EHRs as secure repositories, which allow certified ancillary tools to be integrated into them. The new Application Programming Interface, called Fast Healthcare Interoperability Resources, offers a more granular exchange process of data. Boston-based Massachusetts Institute of Technology researchers also proposed a cryptocurrency-backed system, called MedRec, which would manage medical records with the Ethereum blockchain.
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