Where Will All the Doctors Go? (7/9/2008)
Question: I am about to go on Medicare but my physician is not accepting new Medicare patients. What are my options?
Answer: Have you talked with your physician? Most physicians will continue to see you even after you go on Medicare, especially if you have supplemental insurance. Your physician is probably not seeing “new” Medicare patients. Why?
Because of budgetary problems, the President and the United States Senate have decided to encourage enrollment in Medicare Advantage Plans which are more expensive to fund than ordinary Medicare. In order to pay for those plans Medicare has proposed to cut what it pays physicians by 10%. This will take effect on July 15, 2008 if the Senate cannot come up with a compromise that satisfies the President. Imagine what would happen if you received a 10% reduction in your paycheck.
This is not the total impact of the 10% cut but most physicians see a high percentage of Medicare patients (upwards of 40%), so the cut is real and substantial. Healthcare Soundoff has some ideas for the Senate and President to consider.
Primary care doctors are now in short supply. The Massachusetts universal health plan still cannot be fully implemented because most primary care physicians do not have the time available to see new patients. Perhaps Medicare should look at cuts that point to higher priced procedures and diagnostic tests rather than office visits. Office visits should be maintained at the current levels and probably are due for an increase.
Medicare should pay for virtual office visits. This would allow routine matters to be handled on the internet. Many major health plans now pay for internet visits and the participants, health plans, physicians and patients, are pleased with the results. One of the companies that pioneered this process can be found at www.relayhealth.com.
Physicians are the only professionals that do not use email to regularly communicate. It is time the medical profession found a way to get into the 21st century and allow patients to utilize their time effectively. Most of us now do that through texts or email.
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Another Doctors view
To Dr above.
Quite simply put. I do not trust these MA plans. Though their intent might be right and the objective might seem good for both parties right now.
It seems like a proposition to sleep with the devil. Eventually no matter how good the rationale might be, they will come around to screwing me.
The Insurance industry has never been fair with Primary care doctors. I quite simply do not trust them.
Doctor 9/1/2008 9:36:22 AM
Dr.
Some medical practices are using Medicare Advantage plans to help solve their reimbursement problems, and allow them to take Medicare age patients. For example:
http://www.familyhealth.org/articles/new-medicare-plans-2008
By only accepting patients on these plans, the doctors are able to function as a personal medical home and actually get paid for what their patients need, while the plans get a marketing advantage and well managed patients. http://drdavelynch.blogspot.com/2007/02/joint-principles-of-patient-centered.html
In short, some MA plans are part of the solution. It was this type of value added innovation that Congress was hoping for. Doctors need to lead in this direction in order to avoid "hamster wheel" healthcare.
Dave Lynch 7/24/2008 11:49:23 AM
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