Comments on: This is your reward for continuing to take Medicaid patients http://www.kevinmd.com/blog/2008/01/this-is-your-reward-for-continuing-to.html Wed, 15 Feb 2012 00:27:00 +0000 hourly 1 By: Anonymoushttp://www.kevinmd.com/blog/2008/01/this-is-your-reward-for-continuing-to.html#comment-82908 Anonymous Sun, 20 Jan 2008 22:13:00 +0000 http://clients.emmense.com/kevinmd/2008/01/this-is-your-reward-for-continuing-to-take-medicaid-patients.html#comment-82908 Cutting Medicaid payments to outpatient services, which has been done in various ways by several states results in more physicians dropping out of Medicaid participation. Outpatient practitioners don't lose anything by turning away patients who always lose their practices money. Better not to see them at all.<br/><br/>Correctly and cynically, the state Medicaid agency managers have calculated that hospital-based physicians don't have the same latitude of response; they can't just boot out Medicaid patients who have been admitted. If those doctors are on salary, the hospital eats the loss; if the doctors are on fee-for service, the doctor eats the loss. Unless he quits working at the hospital, there is no way he can get out from under Medicaid.<br/><br/>Hideous but brilliant. Cutting Medicaid payments to outpatient services, which has been done in various ways by several states results in more physicians dropping out of Medicaid participation. Outpatient practitioners don’t lose anything by turning away patients who always lose their practices money. Better not to see them at all.

Correctly and cynically, the state Medicaid agency managers have calculated that hospital-based physicians don’t have the same latitude of response; they can’t just boot out Medicaid patients who have been admitted. If those doctors are on salary, the hospital eats the loss; if the doctors are on fee-for service, the doctor eats the loss. Unless he quits working at the hospital, there is no way he can get out from under Medicaid.

Hideous but brilliant.

]]> By: Gasmanhttp://www.kevinmd.com/blog/2008/01/this-is-your-reward-for-continuing-to.html#comment-82773 Gasman Wed, 16 Jan 2008 16:36:00 +0000 http://clients.emmense.com/kevinmd/2008/01/this-is-your-reward-for-continuing-to-take-medicaid-patients.html#comment-82773 Gripes aren't worth much unless enough people are willing to make the credible threat to quit medicare, then reaffirm the credibility by following through. Gripes aren’t worth much unless enough people are willing to make the credible threat to quit medicare, then reaffirm the credibility by following through.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/01/this-is-your-reward-for-continuing-to.html#comment-82771 Anonymous Wed, 16 Jan 2008 16:00:00 +0000 http://clients.emmense.com/kevinmd/2008/01/this-is-your-reward-for-continuing-to-take-medicaid-patients.html#comment-82771 Mainecare is a mess. They have one of the highest per capita enrollments in Medicaid (around 20% of the population) and very low reimbursement, even by Medicaid standards. They have promised so much to so many people without enough money to pay for it all. They're going after the hospitals because they're forced to accept Mainecare and because the private docs are going out of business or dropping Mainecare. Mainecare is a mess. They have one of the highest per capita enrollments in Medicaid (around 20% of the population) and very low reimbursement, even by Medicaid standards. They have promised so much to so many people without enough money to pay for it all. They’re going after the hospitals because they’re forced to accept Mainecare and because the private docs are going out of business or dropping Mainecare.

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