Wednesday, May 30, 2012

Nail number 27 in the Coffin


HHS recently released new guidelines outlining who can be a provider in a hospital setting.  The headline reads:
 
HHS FINALIZES NEW RULES TO CUT REGULATIONS FOR HOSPITALS AND HEALTH CARE PROVIDERS, SAVING MORE THAN $5 BILLION
Four changes were announced, including this one:
Require that all eligible candidates, including advanced practice registered nurses and physician assistants, be reviewed by medical staff for potential appointment to the hospital medical staff and then be granted all of the privileges, rights, and responsibilities accorded to appointed medical staff members.”
With this change, an APRN (Advanced Practice Registered Nurse) or PA (Physician's Assistant) can do everything a doctor can do at an 85% reimbursement rate of a doctor.  The government will save significant monies if they are paying 15% less for the same service by virtue of the fact that a doctor is not performing the procedure.  One of the stated advantages is to free up doctors for more complex cases, but the real advantage is financial.  In addition to collecting less, these mid level providers also cost a hospital less with salaries being half that of a physician.  So, even though the hospital will get a reduced payment, they will not have the overhead associated with doctors.

If these rules are approved, then hospitals will be able to reduce their physician staff to the bare minimum to handle the more complex cases and hire on less expensive APRN’s and PA’s to do the work currently being done by Doctors.
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