Health care reform's effects on physicians described

Health care reform will increase the appeal of primary care as a career and push physicians toward practice integration or hospital employment, according to a new paper by White House officials.

The article, released online yesterday by Annals of Internal Medicine, addresses the opportunities and challenges of the Affordable Care Act. The authors—Robert Kocher, MD, Ezekiel Emanuel, FACP, and Nancy-Ann M. DeParle, JD—note that in addition to increasing patient access to physicians through expansion of insurance coverage, the act includes a number of provisions affecting physician practice.

The implementation of electronic health records—and their use in patient tracking, teamwork and patient outcome orientation—will be encouraged by $25 billion in incentives, the article noted. The new law also moves away from the fee-for-service system by establishing patient-centered medical homes and accountable care organizations, as well as pilots of bundled payments. These changes will drive greater integration of the health care system, with physicians either organizing themselves into larger groups or joining hospitals, the article predicted.

Physicians will also be encouraged to practice in primary care by a 10% bonus for qualified primary care physicians and increased funding for the National Health Service Corps. Additional funding for medical education and provisions to reduce administrative paperwork should also have a positive effect on the primary care system, the article noted.

The failure of the reform plan to fix the sustainable growth rate formula is disappointing, but this limitation should not distract physicians from the provisions that can benefit them and their patients, the officials advised.