Impact of Health Care Reform on the Independent GI Practice

Gastrointestinal Endoscopy Clinics of North America

Volumn 22, Issue 1, 2012, Pages 15-27

  Mergener, Klaus ^a  

^a Multicare Health System   (United States)

Author keywords

Affordable Care Act (ACA); Endoscopy; Gastroenterology; Health care; Independent practice; Patient Protection and Affordable Care Act (PPACA); Private practice; Reform

Indexed keywords

AMBULATORY CARE; CAPITAL; COLONOSCOPY; COST CONTROL; ELECTRONIC MEDICAL RECORD; EMPLOYMENT; FINANCIAL MANAGEMENT; GASTROENTEROLOGY; GASTROINTESTINAL ENDOSCOPY; HEALTH CARE COST; HEALTH CARE DELIVERY; HEALTH CARE POLICY; HEALTH CARE QUALITY; HEALTH CARE SYSTEM; HEALTH CARE UTILIZATION; HEALTH INSURANCE; HOSPITAL PERSONNEL; HUMAN; LAW; MEDICAL FEE; MEDICAL PRACTICE; MEDICARE; PRIORITY JOURNAL; REIMBURSEMENT; REVIEW; UNITED STATES;

DELIVERY OF HEALTH CARE; GASTROENTEROLOGY; HEALTH CARE REFORM; HUMANS;

EID: 81555196448     PISSN: 10525157     EISSN: 15581950     Source Type: Journal    
DOI: 10.1016/j.giec.2011.09.004     Document Type: Review

References (51)

1. Organization for Economic Development. OECD Health Data 2011, published June 2011. Available at: Accessed August 25, 2011. http://www.oecd.org/health/healthdata.
2. Sisko A.M., Truffer C.J., Keehan S.P., et al. National health spending projections: the estimated impact of reform through 2019. Health Aff (Millwood) 2010, 29(10):1933-1941.
3. Littenberg G. Where will health reform take GI practice?. Gastrointest Endosc 2010, 72(2):396-400.
4. Davis K., Schoen C., Schoenbaum S.C., et al. Mirror, mirror on the wall: an international update on the comparative performance of American health care 2007, The Commonwealth Fund, New York, Available at:, Accessed August 25, 2011. http://www.commonwealthfund.org/Publications/Fund-Reports/2007/May/Mirror%13Mirror-on-the-Wall%13An-International-Update-on-the-Comparative-Performance-of-American-Healt.aspx.
5. Dorn S.D. United States health care reform in 2009. A primer for gastroenterologists. Clin Gastroenterol Hepatol 2009, 7:1168-1173.
6. Berwick D.M., Nolan T.W., Whittington J. The triple aim: care, health, and cost. Health Aff (Millwood) 2008, 27(3):759-769.
7. Gawande A. Cowboys and pit crews. Harvard Medical School Commencement Address, 2011. Available at: Accessed August 25, 2011. http://www.hcfms.com/Uploads/SharedDocuments/GawandeCommencement2011.pdf.
8. Frakes J.T. Outpatient endoscopy. The case for the ambulatory surgery center. Gastrointest Endosc Clin N Am 2002, 12(2):215-227.
9. Vicari JJ. The future value of ambulatory endoscopy centers in the United States. Challenges and opportunities. Gastrointest Endosc, in press.
10. Available at: Accessed August 31, 2011. http://www.gpo.gov/fdsys/pkg/PLAW-111publ148/content-detail.html.
11. Available at: Accessed August 31, 2011. http://www.gpo.gov/fdsys/pkg/PLAW-111publ152/content-detail.html.
12. Available at: Accessed August 31, 2011. http://www.recovery.gov/About/Pages/The_Act.aspx.
13. Available at: Accessed August 31, 2012. http://www.kff.org/healthreform/upload/8061.pdf.
14. Available at: Accessed August 31, 2011. http://www.loc.gov/crsinfo.
15. Available at: Accessed August 31, 2011. http://www.ama-assn.org/ama1/pub/upload/mm/399/hr3590-summary-of-provisions.pdf.
16. Available at: Accessed August 28, 2011. http://online.wsj.com/article/SB10001424053111904006104576504383685080762.html.
17. Bagheera to Mowgli in " The Jungle Book" (Walt Disney's 1967 animated film version of Rudyard Kipling's story).
18. Wayne Gretzky. Available at: Accessed September 28, 2011. http://en.wikipedia.org/wiki/Wayne_Gretzky.
19. Kocher R., Emanuel E.J., DeParle N.A. The Affordable Care Act and the future of clinical medicine: the opportunities and challenges. Ann Intern Med 2010, 153:536-539.
20. Holahan J, Dom S. What is the impact of the Patient Protection and Affordable Care Act (PPACA) on the States? Available at: Accessed August 31, 2011. http://www.rwjf.org/files/research/65049.pdf.
21. Foster R.S. Estimated financial effects of the " Patient Protection and Affordable Care Act," as amended. memorandum 2010, Centers for Medicare and Medicaid Services, Baltimore (MD), Available at:, Accessed August 31, 2011. http://www.cms.gov/ActuarialStudies/Downloads/PPACA_2010-04-22.pdf.
22. Kaiser Family Foundation. The uninsured: a primer. Key facts about Americans without health insurance. Available at: Accessed August 31, 2011. http://www.kff.org/uninsured/upload/7451-06.pdf.
23. Medicaid-to-Medicare fee index. Available at: Accessed August 31, 2011. http://www.statehealthfacts.org/comparetable.jsp%3Find=196%26cat=4.
24. Vladeck B.C. Fixing Medicare's physician payment system. N Engl J Med 2010, 362:1955-1957.
25. Available at: Accessed August 31, 2011. http://www.dartmouthatlas.org.
26. Gawande A. The cost conundrum. Available at: Accessed August 31, 2010. http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande.
27. Colmers J.M. Commonwealth Fund Commission on a high performance health system. Public reporting and transparency 2007, The Commonwealth Fund, New York.
28. Shea K.K., Shih A., Davis K. Commonwealth Fund Commission on a high performance health system data brief: health care opinion leaders' views on health care delivery system reform 2008, The Commonwealth Fund, New York.
29. Ginsburg P.B. Rapidly evolving physician-payment policy-more than the SGR. N Engl J Med 2011, 364:172-176.
30. Available at: Accessed August 31, 2011. http://www.medicare.gov/find-a-doctor/provider-search.aspx.
31. Available at: Accessed August 31, 2011. http://www.hospitalcompare.hhs.gov.
32. Available at: Accessed August 31, 2011. http://fairhealthconsumer.org.
33. Bundled payments-Medicare pilot program. Health reform GPS: a joint project of the George Washington University and the Robert Wood Johnson Foundation. Available at: Accessed August 31, 2011. http://healthreformgps.org/resources/bundled-payments-%25E2%2580%2593-medicare-pilot-program.
34. Miller H.D. From volume to value: better ways to pay for health care. Health Aff (Millwood) 2009, 28(5):1418-1428.
35. Satin D.J., Miles J. Performance based bundled payments: potential benefits and burdens. Minn Med 2009, 92(10):33-35.
36. RAND Corporation. Overview of bundled payment. Available at: Accessed August 31, 2011. http://www.randcompare.org/policy-options/bundled-payment.
37. Mechanic R.E., Altman S.H. Payment reform options: episode payment is a good place to start. Health Aff (Millwood) 2009, 28(2):262-271.
38. Casale A.S., Paulus R.A., Selna M.J., et al. " ProvenCare": a provider-driven pay-for- performance program for acute episodic cardiac surgical care. Ann Surg 2007, 246(4):613-621.
39. Hussey P.S., Eibner C., Ridgely M.S., et al. Controlling U.S. health care spending-separating promising from unpromising approaches. N Engl J Med 2009, 361(22):2109-2111.
40. Fisher E.S., McClellan M.B., Bertko J., et al. Fostering accountable health care: moving forward in Medicare. Health Aff (Millwood) 2009, 28(2):219-231.
41. Levey, N. Healthcare law has more doctors teaming up. Los Angeles Times. July 28, 2010. Available at: Accessed September 28, 2011. http://articles.latimes.com/2010/jul/28/nation/la-na-health-doctors-20100728.
42. The Brookings Institution. Overview of the 2009-2010 Brookings-Dartmouth ACO Learning Network. 2010. Available at: Accessed August 31, 2010. https://xteam.brookings.edu/bdacoln/Pages/OverviewoftheNetworkMembership.aspx.
43. WSJ: United buying doctors. Available at: Accessed August 31, 2011. http://online.wsj.com/article/SB10001424053111903895904576542553422509280.html.
44. Weaver C. Managed care enters the exam room as insurers buy doctor groups. Available at: Accessed August 25, 2011. http://www.kaiserhealthnews.org/Stories/2011/July/01/unitedhealth-insurers-buy-doctors-groups.aspx.
45. Singer S., Shortell S.M. Implementing accountable care organizations. Ten potential mistakes and how to learn from them. JAMA 2011, 306(7):758-759.
46. Blumenthal D., Tavenner M. The " meaningful use" regulation for electronic health records. N Engl J Med 2010, 363(6):501-504.
47. Brill JV, Kosinski LR. What GI practices need to know about meaningful EHR use. 2011. Available at: Accessed August 25, 2011. http://www.gastro.org/aga_meaningful_use.pdf.
48. Available at: Accessed August 31, 2011. http://www.physiciansfoundation.org/uploadedFiles/PF%5fSurvey%5fReport%5fNov08.pdf.
49. Isaacs S.L., Jellinek P.S., Ray W.L. The independent physician-going, going. N Engl J Med 2009, 360(7):655-658.
50. Kocher R., Sahni N.R. Hospitals race to employ physicians-the logic behind a money-losing proposition. N Engl J Med 2011, 364:1790-1793.
51. Cantlupe J. Physician alignment in an era of change 2010, HealthLeaders Media, Brentwood (TN), Available at:, Accessed August 31, 2011. http://www.healthleadersmedia.com/page-2/MAG-256427/Physician-Alignment-in-an-Era-of-Change.