Alaska Doctors Hit by Federal Overregulation

Published November 24, 2014

Kaiser Health News offers a pretty good roundup of stories each day on health care, and anybody who wants to stay on top of things would be well advised to subscribe to their daily e-mail (it’s free). KHN also routinely partners with other news outlets to produce news stories, and these are often informative too.

One recent KHN story explained how three federal regulations and policies are crushing primary care physicians in Alaska, a state dominated by rural populations and solo- or small-group practices:

Alaska Doctors Overwhelmed By New Federal Rules

Dr. Oliver Korshin, a 71-year-old ophthalmologist in Anchorage, is not happy about the federal government’s plan to have all physicians use electronic medical records or face a Medicare penalty. A few months ago when he applied for an exemption to the latest requirement, he had to pick an exemption category that fit.

“The only one that possibly applied to me was disaster,” Korshin says. “So I picked disaster and I described my disaster as old age and I submitted as my supporting document a copy of my passport.”

Korshin knew that argument probably wouldn’t work, but he still won’t make the switch. Starting next year, the federal government will penalize him – withholding 1 percent of his Medicare payments.

EHR,  ICD-10 and PQRS may sound like alphabet soup. But most doctors around the country know exactly what those acronyms stand for. They are programs championed by the federal government to improve quality and bring medicine into the electronic age. But in Alaska, where small medical practices and an aging physician workforce are common, the new requirements can be a heavy burden…

It isn’t just the electronic health record requirement that is damaging small medical practices. The upcoming release of ICD-10, a new system of medical codes that is literally so convoluted and compehensive that it has a code for burns suffered due to water skis catching fire (V9107XA, in case you’re curious), has many doctors up in arms. On top of that monstrosity, next year doctors will begin to be penalized for not reporting quality data, whatever that means (I’m pretty sure it will have little to do with the actual quality of care delivered, though).

Dr. Korshin summed up these burdens best:

“No possible business model would endorse that kind of implementation in a practice situated like mine, it’s crazy,” he says.”

No, it’s not crazy, it’s just how central planners prefer to do things. And you can be sure it’s not just a few doctors in Alaska that are getting hit with this.