We recently came across the following article about the 21% cut to physician’s fees by Medicare due to take effect because of a longstanding, outmoded formula created in the 1990’s. What’s interesting is that the proposed temporary fix that went into effect at the time this article was written is being proposed a second time as Congress has failed to act once again on behalf of primary care and mental health providers. We’re interested to hear the medical community and consumer’s feedback on this new legislation (or lack thereof).
Medicare Care Givers: Living under the Sword of Damocles
If the United States government is as serious as it says it is about helping elderly and disabled people find quality, affordable health care, it has adopted a funny way of doing it.
It is axiomatic that folks with Medicare can’t find good health care unless there are doctors and other caregivers willing to provide it. It is sometimes difficult to locate a Medicare doctor and there are often long waiting periods for an appointment. There may be many reasons, but one of them is surely that Medicare has traditionally paid doctors less than other payors; there has always been an element of philanthropy on the part of doctors willing to accept Medicare patients.
One would think that if the system wanted to incent doctors to participate with Medicare despite low fees and other problems inherent with interacting with the government, it might try treating doctors with respect and gratitude. But that’s not the way it is. Instead of a hero’s welcome, Medicare doctors can now expect from the government a kind of threatening malevolence.
This black cloud takes at least two important forms. One, there is the issue of fees. Instead of the steady, gradual fee increases one would expect in a reasonable payment system that accounts for inflation and huge increases in the costs of doing business as a medical provider, Medicare annually threatens draconian fee reductions to doctors, only to repeal them at the last moment or to replace them with smaller decreases that don’t get noticed as much. This year’s proposed decrease is approximately 21% and has not yet, at the time of this comment, been repealed. Is it any wonder that Medicare doctors suffer from a chronic feeling that they are undervalued?
Second, and even more frightening, is a relatively new and bizarre idea that is now permeating most of the relationships between Medicare and its doctors. This idea? Medicare doctors are being treated almost like presumptive criminals, guilty until proven innocent, of Medicare “fraud, waste and abuse.” The US government has hired medical bounty hunters with the mandate of catching doctors engaging in fraudulent Medicare billing. They have been directed to recover something in the order of five billion dollars this way. These bounty hunters are now in the process of observing and investigating every provider of Medicare services in America – or at least that’s what they threaten. So, in order to catch what must be a tiny fraction of Medicare doctors actually engaging in fraudulent billing, the government is willing to treat every single Medicare doctor like a felon waiting to be nabbed. To make matters worse, most of the so-called “fraud” these bounty hunters uncover would be characterized by more reasonable people as “documentation errors” or “not enough attention to detail when writing chart notes.” Forgetting to sign every page of a patient’s chart notes is not the same thing as an ongoing, purposeful scheme to defraud the United States government! But woe unto innocent Medicare doctors who get caught up in this bounty hunting scheme. You may be innocent of wrong doing, but it can cost multiple tens of thousands of dollars to prove it. Many practices have had to shut their doors because of the unfairness and violence of this approach to curbing medical billing problems.
If the United States would like to offer its elderly and disabled citizens a health care system that is robust and effective, it should immediately reverse its current policy of threats and blackmail toward doctors, both on the issue of fee reductions and curbing “fraud.” American doctors would happily participate in a system that valued them as professionals, paid them reasonably well, and treated them as they ought to be treated – as full partners in America’s quest to keep its people as healthy.
Here’s another great article from CNN Money.com. I’m posting the text below.
Family Physician
Hackettstown, NJ
When I first started practicing, I spent several years working in group practices. At the time, I felt like a hamster on a wheel, working for my employers, the insurance industry and the government instead of the REAL consumer, my patient.
I felt pressured to churn patient after patient in order for us to ‘break even.’ This experience drove me to open my own practice. Being in solo practice for three years, I feel that I provide excellent level of care. However, the ‘hamster on a wheel’ concept has followed me.
The current reimbursement rates and endless red tape force many primary care physicians to hire more staff and see more patients in order to cover our costs. Our costs continue to rise, driven by rising malpractice premiums and payroll and small business taxes and fees. I know of several physicians that have held their own paychecks for several months in order to make payroll.
The passage of this bill does not fundamentally change the flaws in this system. It has not changed the physician reimbursement formula. It has not changed the need for preapprovals or referrals. To the contrary, we are forced into more bean counting.
I can no longer sustain my practice in this current environment [even though the legislation benefits my patients.] that is the best for my patients. I see no other choice than to force the middleman out and drop Medicare and insurance.
By Parija Kavilanz, senior writer
Great article, thank you very much! RFID Reader
found your site on del.icio.us today and really liked it.. i bookmarked it and will be back to check it out some more later
As a health care provider i am deeply concern about the Medicare cuts and how is going to affect our seniors, there is a lack of respect for the patients and for the health care providers, i say the Medicare cuts could be a silence killer for the older population. Let’s not forget that Medicare recipients pay every month for those benefits and let’s not forget that Medicare participants paid to participate in the Medicare program since they were actively in the work force. Don’t abuse the senior.
[...] This post was mentioned on Twitter by dania velasco. dania velasco said: Will Mental Health Care Be Hurt By Proposed Medicare Cuts? « NC Psychiatry and Psychology Blog: http://bit.ly/bSeQlN [...]
Buy:Cialis Super Active+.Viagra Super Active+.Super Active ED Pack.Cialis Professional.Maxaman.Soma.Viagra Super Force.Cialis.Viagra Professional.Viagra.Zithromax.Cialis Soft Tabs.Tramadol.Viagra Soft Tabs.Propecia.Levitra.VPXL….