Berks County Medical Society Medical Record Winter 2019 - 17

settings or via urgent care centers is already common, and these
settings provide a good alternative to Emergency Departments
for non-life-threatening conditions. We will see more options
such as primary care provided in the home or via telemedicine.
Additional technologies will also come into play, such as wearable
devices that will communicate real-time health data to primary care
providers. We need to be innovative in removing barriers to access
to care, whether that is via technology such as mobile apps, better
transportation options, or providing patients with improved access
to data about pricing and outcomes. While navigators are common
for patients with complex or chronic conditions, it remains to be
seen how they might work in a primary care setting.

What changes might people needing rehabilitation services
in Berks County expect to see over the next 5 years or so?

HealthSouth
Reading
Rehabilitation
Hospital

Independent Practice

How have recent changes in Berks County health care
organizations affected HealthSouth and its plans for the
future? In particular, how has the expansion of physician
practice ownership by Reading Hospital - Tower Health and
its expanding role as a provider of health insurance as well as
health care affected access to rehabilitation services for local
inhabitants? And has the acquisition of St. Joseph Medical
System by Penn State Health had any effect on the operations of
HealthSouth or access to rehab services in general?
Changes in Health Care overall have impacted access to rehab
services. Berks County is no exception to this nationwide change.
As networks narrow and systems grow, access to care is impacted.
Large systems guide patients to stay within their network, which
makes sense in many cases. However, there are also many cases
where going outside the network for Post-Acute care would allow
the patient to benefit from a provider with expertise in their
particular condition versus a provider that is simply within the
system. Not all rehab services are equal and HealthSouth continues
to encourage patient choice and advocacy regarding their care.
There are several Post-Acute providers within Berks County and
patients should make an informed decision when selecting the
appropriate provider, versus a provider that is simply affiliated with
their Physician Practice.

Berks County will experience the same changes that will impact
everyone nationwide. As networks narrow, competition decreases,
insurance companies own providers, and Medicare changes their
payment models all levels of care will be impacted. The most
important thing for patients and their families to do in response to
these changes is to stay educated and informed. Advocating for the
right level of care in the right setting will have significant impact on
outcomes. The likelihood of a patient returning home, returning
back to the hospital, developing an infection, or worse is dependent
on where they receive their care at every step along the way.

Louis La Luna, MD, joined Digestive Disease Associates in
1998 and has worked towards maintaining and strengthening
independent physician practice. We asked him to respond to the
following question:
Is there a role for INDEPENDENT PRACTICE in our
current medical environment?
The answer is YES. The dream of becoming a private practice
doctor is somewhat fuzzy these days. When I first started with
Digestive Disease Associates there were large, strong, independent
primary care and specialty practices that were well respected and
carried a lot of influence in our medical community. They were
made up of doctors who were proud of their work and cared for
their patients, usually from young adulthood to old age both as
outpatients and inpatients. My senior partner's motto was, "if we
provide good medicine everything else will fall into place." That
was true 20+ years ago, however with the ratcheting down of fee
schedules, increasing costs of running a medical practice, and the
complexities of compliance, independent practice is no longer just
about giving good care.
Independent practice not only requires high quality medical
skill but also the need for strong operational management. This
comes at a high financial cost which can only be overcome by
size and alternative income streams. Though both employed and
independent physicians are tasked with providing high quality
care, independent practices create a market place balance alongside
of non-profit hospital systems and for-profit corporate based
medical care suppliers. There is an important collaboration between
independent practice and health care systems and each plays a
critical role in healthcare economics, patient choice and physician
satisfaction which leads to the ultimate goal of high quality,
efficient, cost effective medical care.
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WINTER 2019

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Berks County Medical Society Medical Record Winter 2019

Table of Contents for the Digital Edition of Berks County Medical Society Medical Record Winter 2019
