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A family practice that serves over 4,500 patients is owned by three brothers, all general practitioner medical doctors who have been closely watching how the new Patient Protection and Affordable Care Act (ACA or “Obamacare”) is developing, especially with the ongoing changes to the eligibilities of coverage for patients and reimbursements that now require their facility to change its systems and processes for compliance.

Scenario:

A family practice that serves over 4,500 patients is owned by three brothers, all general practitioner medical doctors who have been closely watching how the new Patient Protection and Affordable Care Act (ACA or “Obamacare”) is developing, especially with the ongoing changes to the eligibilities of coverage for patients and reimbursements that now require their facility to change its systems and processes for compliance.

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As a healthcare consultant, you have been retained by the family practice to perform a thorough audit and analysis of the facility, including its systems, processes, and procedures, with an emphasis on record keeping and coding/billing practices.

You have also spent some time with the owners of the family practice discussing what the future holds regarding the types of treatments, demographics of patients, and the effect of technology on the methodologies of patient treatment. Within this context, the client asks you to provide the following:

Questions:

When comparing the overall health care system in America, how does it compare to just 40

years ago?

Provide some examples of what specifically is critical for the healthcare organization to consider regarding how treatments are performed on patients.

What technological advancements do you predict in health care in the next 15 years, especially those that can be opportunities for a family medical clinic scenario?

What are the regulatory agency changes coming in the near future?

What are your predictions for the success of the ACA, especially in the next 5 years?

Solution Preview


*Health care system in America 40 years ago,most doctors were still independent and compensated through fee-for-service. By mid 1980 Health maintenance organizations(HMO) began to dominate both the organizations of health care and reimbursement to ph…

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