A reader of The Self-Pay Patient asked whether, as a self-pay patient, their private medical records would be available to the government or insurance companies as a result of the electronic health records mandate contained in Obamacare.
I’ve looked around a little and it appears that for primary care, if you go to a cash-only doctor or at least one that doesn’t accept Medicare, then there effectively is no mandate that doctors move their medical records into the digital age. This is because the only penalty I’ve been able to find for not adopting electronic health records in a medical practice is a reduction in Medicare reimbursements. No Medicare patients = no penalty, so no mandate.
The number of doctors that opt out of Medicare is growing each year, as is the number deciding to go cash-only and ditch insurance altogether. An excellent source for finding doctors that are not accepting insurance or participating in Medicare is the web site of the Association of American Physicians and Surgeons, which maintains a list of cash/direct payment friendly practices.
It should also be noted that despite substantial incentives for doctors’ offices to adopt electronic health records, implementation seems to be going slow as many health care providers are questioning the value of abandoning their traditional record keeping methods. Also, just because a doctor doesn’t participate in Medicare or other insurance programs doesn’t mean they don’t have electronic health records – some do find them to be a valuable part of their practice. So be sure and ask the doctor’s office ahead of time if this is a concern of yours.
Finding a doctor that doesn’t use electronic health records shouldn’t be too difficult, as long as there are cash-only practices near you. The same can’t be said for hospitals however – nearly every hospital in the country takes Medicare, meaning they will have to adopt electronic health records or face a reduction in payments. In fact I’m not aware of a single hospital in the country that doesn’t accept Medicare (readers, please tell me if you know of one!).
Depending on how you feel about electronic health records, this may pose a problem for you. If it does, one option you might consider would be what is known as medical tourism, going overseas to seek medical care. It’s not for everyone or every situation, but doing so can address certain privacy issues that some people have. In addition, as a self-pay patient you can typically get a much lower price for procedures performed outside the country compared to what they might be charged at most hospitals in the U.S. I’ll be blogging about that soon.