On Day 2 at the AHLA Physicians and Hospital Law Institute, three themes ruled the day. Here’s a quick recap:
A technology driven revolution is taking place in healthcare. The traditional patient/physician relationship is changing, and consumer demand will cause telehealth to become mainstream healthcare. Remote access and patient monitoring will become more prevalent. Access to care will improve, as it will be available in locations where it is limited, or doesn’t exist, today.
The Federation of State Medical Boards (FSMB) has adopted the “Model Policy for the Appropriate Use of Telemedicine Technologies in the Practice of Medicine.” Leadership in your facilities should be familiar with FSMB policies.
Fraud and Abuse
In 2014, $3B was recovered industry-wide from fraud and abuse cases. $333M was recovered from hospitals, and $435M was paid to whistleblowers. Cases come in all shapes and sizes, but the most common are schemes that violate:
1) Federal anti-kickback rules
2) Physician self-referral prohibitions
3) Billing for services that were unnecessary, excessive, or not delivered
The strategy driving mergers is changing from market share and cost savings to product and geographical expansion. You shouldn’t count on eliminating redundancy on Day 1. Culture is critical in making a merger work, so respect and honor the past. Setting up integration teams as best-practice design teams has proven to be a successful implementation strategy.
The 2015 AHLA Physicians and Hospital Law Institute reinforced that the rate of change and level of uncertainty in healthcare have greatly accelerated. However, with great change comes great opportunity. Providers with healthy organizations, solid governance models, and excellent leadership are likely to thrive. Providers without these things in place might not survive.
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