Comments on: When Medicare and Medicaid are your best payers http://www.kevinmd.com/blog/2008/11/when-medicare-and-medicaid-are-your.html Tue, 14 Feb 2012 21:09:00 +0000 hourly 1 By: Anonymoushttp://www.kevinmd.com/blog/2008/11/when-medicare-and-medicaid-are-your.html#comment-88026 Anonymous Mon, 10 Nov 2008 00:35:00 +0000 http://clients.emmense.com/kevinmd/2008/11/when-medicare-and-medicaid-are-your-best-payers.html#comment-88026 If we withheld our services for one week, by statue or executive order you would find that the rules would change such that when you enroll as a provider for Medicaid and Medicare, you agree to never withhold services (ie strike) and that you are subject to permanent termination and substantial fines should you do so. The government more and more panders to the idea that health care is a right, not a commodity. If health care is a right, then those who provide it are slaves and do not themselves have any rights. If we withheld our services for one week, by statue or executive order you would find that the rules would change such that when you enroll as a provider for Medicaid and Medicare, you agree to never withhold services (ie strike) and that you are subject to permanent termination and substantial fines should you do so. The government more and more panders to the idea that health care is a right, not a commodity. If health care is a right, then those who provide it are slaves and do not themselves have any rights.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/11/when-medicare-and-medicaid-are-your.html#comment-87993 Anonymous Sat, 08 Nov 2008 02:39:00 +0000 http://clients.emmense.com/kevinmd/2008/11/when-medicare-and-medicaid-are-your-best-payers.html#comment-87993 I think it is time for the AMA to get a back-bone and start to stand up for our rights. This organization is such a weak respresentation for our profession...they have allowed so much of our rights and respnsibilities to be controlled by others (insurance companies, government) and have allowed the physician extenders and for profit clinics in pharmacies to take away some of the responsbility that was regulated the role of the physician. We physicians need to stand up for our rights. We aren't forced to accept medicare or medicaid. If EVERY doctor refused to care for or see any of these patients FOR JUST ONE WEEK...things would change very quickly. But we all have to work together and STAND STRONG. Once we band together and force the issue and show the government that we can bring health care to a standstill we will never get our of the clutches of others telling us what to do and depending on them to reimburse us for our services months after those services were rendered. Perhaps once we do this, we will become a proud profession who can serve the health of our patients instead of being held hostage by the insurance companies and the poor payments of medicare and medicaid. mark my word, if we don't do something SOON, the new crop of physicians will choose speciality training and concierge medicine and there WILL BE NO ONE to care for the people who need us most. I think it is time for the AMA to get a back-bone and start to stand up for our rights. This organization is such a weak respresentation for our profession…they have allowed so much of our rights and respnsibilities to be controlled by others (insurance companies, government) and have allowed the physician extenders and for profit clinics in pharmacies to take away some of the responsbility that was regulated the role of the physician. We physicians need to stand up for our rights. We aren’t forced to accept medicare or medicaid. If EVERY doctor refused to care for or see any of these patients FOR JUST ONE WEEK…things would change very quickly. But we all have to work together and STAND STRONG. Once we band together and force the issue and show the government that we can bring health care to a standstill we will never get our of the clutches of others telling us what to do and depending on them to reimburse us for our services months after those services were rendered. Perhaps once we do this, we will become a proud profession who can serve the health of our patients instead of being held hostage by the insurance companies and the poor payments of medicare and medicaid. mark my word, if we don’t do something SOON, the new crop of physicians will choose speciality training and concierge medicine and there WILL BE NO ONE to care for the people who need us most.

]]> By: Deron Schriverhttp://www.kevinmd.com/blog/2008/11/when-medicare-and-medicaid-are-your.html#comment-87992 Deron Schriver Sat, 08 Nov 2008 02:10:00 +0000 http://clients.emmense.com/kevinmd/2008/11/when-medicare-and-medicaid-are-your-best-payers.html#comment-87992 It's sad to say, but the days of the solo or two physician practice are probably numbered. You need at least some level of economies of scale to survive today. My group has 6 physicians and 4 midlevels, which allows them to afford someone like me who can negotiate with insurance companies and handle day to day operations. As a result, my docs are well compensated. It’s sad to say, but the days of the solo or two physician practice are probably numbered. You need at least some level of economies of scale to survive today. My group has 6 physicians and 4 midlevels, which allows them to afford someone like me who can negotiate with insurance companies and handle day to day operations. As a result, my docs are well compensated.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/11/when-medicare-and-medicaid-are-your.html#comment-87988 Anonymous Sat, 08 Nov 2008 00:26:00 +0000 http://clients.emmense.com/kevinmd/2008/11/when-medicare-and-medicaid-are-your-best-payers.html#comment-87988 Medicare has been the best payer in the NYC area for at least the last 5 years (as long as i've been in practice). In some cases, commercial insurers pay even less than mediCAID (ghi, hip, oxford, blue-cross).<br/><br/>But the thing that irritates me most about the devolution of primary care is the so-called "team" approach. All of these idiots outside actual patient care think it's a great idea to expand the "team" with useless individuals just sucking off medicare resources and providing no value. In some cases they actually complicate care & worsen outcomes. Sadly, visiting nurses is a good example, pertaining to the elderly. They get paid big bucks from medicare & add NOTHING to the care of the patient, with rare (or no) communication with the primary doctor.<br/><br/>What needs to happen with primary care is as follows:<br/><br/>1) Put the DOCTOR back in charge again.<br/>2) Pay him enough to hire a good nurse, biller, and social worker. These are really all the ancillaries that an efficient office needs.<br/>3) Reinforce to patients that they have some responsibility for their own health & well-being.<br/>4) When in doubt, see (1) Medicare has been the best payer in the NYC area for at least the last 5 years (as long as i've been in practice). In some cases, commercial insurers pay even less than mediCAID (ghi, hip, oxford, blue-cross).

But the thing that irritates me most about the devolution of primary care is the so-called "team" approach. All of these idiots outside actual patient care think it's a great idea to expand the "team" with useless individuals just sucking off medicare resources and providing no value. In some cases they actually complicate care & worsen outcomes. Sadly, visiting nurses is a good example, pertaining to the elderly. They get paid big bucks from medicare & add NOTHING to the care of the patient, with rare (or no) communication with the primary doctor.

What needs to happen with primary care is as follows:

1) Put the DOCTOR back in charge again.
2) Pay him enough to hire a good nurse, biller, and social worker. These are really all the ancillaries that an efficient office needs.
3) Reinforce to patients that they have some responsibility for their own health & well-being.
4) When in doubt, see (1)

]]> By: Dr. Valhttp://www.kevinmd.com/blog/2008/11/when-medicare-and-medicaid-are-your.html#comment-87985 Dr. Val Fri, 07 Nov 2008 22:43:00 +0000 http://clients.emmense.com/kevinmd/2008/11/when-medicare-and-medicaid-are-your-best-payers.html#comment-87985 And nurses are NOT going to pick up the slack. The math doesn't work for any primary care provider. <br/><br/>http://getbetterhealth.com/nurses-may-not-fill-the-primary-care-shortage-were-not-suckers/2008.11.07 And nurses are NOT going to pick up the slack. The math doesn’t work for any primary care provider.

http://getbetterhealth.com/nurses-may-not-fill-the-primary-care-shortage-were-not-suckers/2008.11.07

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/11/when-medicare-and-medicaid-are-your.html#comment-87981 Anonymous Fri, 07 Nov 2008 19:42:00 +0000 http://clients.emmense.com/kevinmd/2008/11/when-medicare-and-medicaid-are-your-best-payers.html#comment-87981 I practice in Las Vegas, where the iron grip of some insurers (Sierra, United Health) has made medicare my BEST payor. Of course, with the recent switch to Palmetto, medicare isn't even paying me which=pain.<br/><br/>I suppose that means that "single" payor might even benefit me, since I am so poorly reimbursed by private insurers. I practice in Las Vegas, where the iron grip of some insurers (Sierra, United Health) has made medicare my BEST payor. Of course, with the recent switch to Palmetto, medicare isn’t even paying me which=pain.

I suppose that means that “single” payor might even benefit me, since I am so poorly reimbursed by private insurers.

]]> By: Chuck Brookshttp://www.kevinmd.com/blog/2008/11/when-medicare-and-medicaid-are-your.html#comment-87979 Chuck Brooks Fri, 07 Nov 2008 18:49:00 +0000 http://clients.emmense.com/kevinmd/2008/11/when-medicare-and-medicaid-are-your-best-payers.html#comment-87979 Concierge/private medicine is looking better and better. It would also help if patients/customers took a more responsible role in maintaining their own health, their most valuable asset.<br/><br/>Chuck Brooks<br/>FutureWare SCG Concierge/private medicine is looking better and better. It would also help if patients/customers took a more responsible role in maintaining their own health, their most valuable asset.

Chuck Brooks
FutureWare SCG

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