Southern Ohio must find way to save its doctors

Published 12:00 am Sunday, June 6, 2010

In the last article I showed how southern Ohio doctors practicing in Lawrence, Jackson, Pike, Scioto, Adams, Brown and Clermont counties have on average a higher caseload of patients in government-run care than the rest of the U.S.

According to U.S. Census figures, in 2006 (latest data) 1 in 7 U.S. citizens were on Medicaid, the government insurance program for the financially vulnerable. In Southern Ohio, however, the density is even higher at 1 in 4, a whopping 25 percent of the population!

Further, I showed how government run care pays doctors on average a much lower reimbursement rate than commercial insurance plans — even below costs, and, under health care reform our doctors can expect an even higher percentage of patients in government run care.

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(Ohio will be required under reform to extend Medicaid benefits from those earning 90 percent of the federal poverty level to those earning up to 133 percent, adding approximately 53,500 persons in Southern Ohio to the program.)

Southern Ohio doctors are already financially strained and adding substantially more patients in government run care may be the tipping point for some to shutter their doors and leave town.

Today, southern Ohio should take two forward thinking and decisive steps to improve the practice of health and attract new doctors to our region: 1) establish a regional medical communications network; and 2) stand-up a back-office shared services center for providers.

A medical communications network entails creating a network which documents and integrates practice data across providers in the region.

This capability will enable doctors to readily and securely access medical information and history of patients coming through their doors, thereby improving the quality of collaborative treatment across providers and driving down doctors’ overhead costs associated with exchanging information.

The first task in setting up the network is to establish a common vocabulary or language for providers to communicate. Medical terms, their definitions and contextual use will need to be standardized and commonly understood across provider disciplines so information can be intelligently understood by all.

This will require establishing a medical information exchange board to determine which terms are standardized and how their meaning is agreed upon.

The next step is to establish technical standards and architecture for the capture, management and exchange of data. This will entail creating a technical standards board that will set technical standards and also oversee build out of the technical infrastructure that will host the network (e.g., hardware, software, hosting environment).

Back-office shared services center refers to a capability that will centrally manage for participating providers select portions of the business side of their practice, e.g., billing, collection, Medicare/Medicaid program compliance, etc.

These activities are often a nightmare for doctors and eat considerably into their profits in terms of office staff and paperwork.

Doctors using these centers would see profits go up from more efficient management of the business side of their practice and have more time to devote to the delivery of care.

Both the medical communications network and back-office shared services center would potentially attract more doctors to our region.

The prospect of opening a practice where there is less of a hassle with managing practice data, haggling with insurance companies and pushing paperwork could provide enough draw for new doctors to locate in southern Ohio.

These two steps are bold and they will require leadership at both the state and local level, with inputs from patients, doctors and other health care providers, the business community and more.

With strong leadership it can be done. The time to act is now.

Joe Green is from Piketon, Ohio, is President & CEO of NPRC, a management consulting firm, and may be reached via e-mail at