How Obamacare Will Impact Reproductive Health

Paul R. Brezina; Anish A. Shah; Evan R. Myers; Andy Huang; Alan H. DeCherney


Semin Reprod Med. 2013;31(3):189-197. 

In This Article

Effect on Specialists

In the United States, specialists are financially compensated at higher rate as compared with primary care physicians.[47] In 2010 the average compensation for a primary care physician was estimated to be approximately $100 per hour; a specialist's hourly rate was around $200.[47] Many believe that the payment modifications that will be enacted over the coming years will be disproportionately directed at curbing reimbursement for relatively high-paid specialist physicians.[47]

The Electronic Medical Record

Although not a direct part of the PPACA, there has been a series of legislative measures aimed at transitioning the medical record to an electronic-based format. Currently only ~34% of office-based physicians use at least a basic EMR system.[48] A driver for the widespread implementation of the EMR is to establish a mechanism capable of tracking medical treatments and patient outcomes centrally.[48–50] In the parlance of these measures, a stated goal of the federal government is to establish "meaningful use" of the EMR.[51] According to the Centers for Disease Control and Prevention, meaningful use "is defined by the use of certified EHR technology in a meaningful manner (e.g., electronic prescribing); ensuring that the certified EHR technology is connected in a manner that provides for the electronic exchange of health information to improve the quality of care; and that in using certified EHR technology the provider must submit to the secretary of the DHHS information on quality of care and other measures."[52]

In an effort to catalyze the adoption of the EMR broadly, the DHHS has created incentives for compliant practices/hospitals including many financial incentives.[51] However, challenges for universal adoption of the EMR exist. High start-up, maintenance, and training costs are barriers for many practices.[38] The average cost to purchase an EMR system for a small practice is estimated to be as much as $50,000 per physician.[38] Additionally, privacy legislation such as the Health Information Technology for Economic and Clinical Health (HITECH) Act have presented challenges to the widespread adoption of the EMR.[51] Although there is a clear trend toward the EMR becoming the dominant form of recordkeeping, it is currently unclear as to when and how this ultimate transition will occur.