During week one, I did extensive research to understand commercial health insurance including premiums and copayments, Medicare and Medicaid, the Affordable Care Act, and new models for doctor reimbursement namely MACRA (Medicare Access and CHIP Reauthorization Act of 2015) and MIPS (Merit-Based Incentive Payment Systems). I spoke to my onsite advisor, Dr. Bergstrom, and had a great conversation learning about the microeconomics of a medical business and how health insurance works.
I met a lot of people in the office who were all welcoming and excited to help me with my project. The medical practice I am interning with specializes in Rheumatology; so I met with six doctors, three nurse practitioners, and one physician assistant who work there. One of the physicians takes care of children with arthritis and I would like to learn more about the rheumatologic diseases that affect children from her. The office employs three triage nurses, three front office personnel, seven medical assistants and a few infusion specialists. They told me about some of their own personal experiences with the changes in health care and insurance coverage.
I am excited to work with the billing specialist who records the insurance coverage and the costs of the business. I will spend time next week with her understanding how insurance companies are billed for patient care.
I learned about the interactions medical businesses have with insurance companies in terms of acquiring authorization for expensive medications. I also got a chance to familiarize myself with with some of the medical technology and instruments used in the office. I learned how patient visits are documented using Electronic Health Records (EHRs).
During week one, I learned that health care in our country is extremely complicated and very expensive.