A guest column by the American Medical Association, exclusive to KevinMD.com.This week, I’m joining hundreds of physicians and medical students in Washington, DC during the American Medical Association’s National Advocacy Conference to talk to our federal lawmakers about an end to what has become an annual chore of stopping drastic scheduled Medicare physician payment cuts to preserve access to health ...
Posts tagged Medicare
Benefits of the Medicare Adult Wellness Visit
One of the things I love about family medicine is that I get to care for people of all ages. I almost went into pediatrics, but the time I spend with older adults was too valuable to give up. Our elders have such great stories and knowledge to impart - it’s an honor to participate in their lives and share their experience.Since I first realized in residency training that Medicare ...
How will the Baby Boomers age and die?
I love listening to life stories. As a hospice chaplain, I loved sitting with our patients and their loved ones engaging in what many hospice teams call “life review.” When did you meet your spouse? When was Reggie born? What is your favorite holiday? When did you learn you were ill? A few simple questions and the stories come pouring forth.Of late, I’ve been listening to the life stories of ...
The patient reality of a Medicare payment cut
Dear United States House of Representatives and Senate:I really hope that you enjoy your Christmas break going back home to your families. While you're home, I really hope that you will hear from those constituents who will be affected by the 27.4 percent Medicare physician pay reduction that is schedule to take effect January 1st. I really hope that the American Academy of Family Physicians, the American Medical Association, ...
Dropping out of Medicare will break my heart
I met with my staff yesterday to discuss the effect of a 27% cut in Medicare reimbursement on our patients and our office. I had a really lousy day, explaining to my elders what would happen if Congress fails to act. One of my patients aptly pointed out that Congress has not acted responsibly in the last 20 years and that it would take a miracle for them to get their ...
Primary care doctors are set to lose more than half of their salary
Fortunately, the 27% reduction in Medicare payments to physicians that is set to take place in a matter of weeks unless congress acts is getting some press. Fox News published a piece recently, as did the Washington Post. Writer Merrill Goozner breaks things down nicely in his article, "Is There a Doctor Fix in the House ... and Senate?"However, one thing that seems to be getting confused in all ...
Billing an established patient visit as a consultation
Until recently, there was a financial difference between performing a "consultation" and a "new patient visit" for office visits (Medicare stopped paying for consultations at a higher rate than new patient visits in 2010).In specialists’ offices, patients often got billed for the more expensive “consults” when in fact the visit was not a consultation at all. Let’s just use this understanding as the brief background for what I’m about to say.I ...
How patient satisfaction scores reward rich hospitals
Medicare is beginning to tie financial bonuses to hospital patient satisfaction scores.Although patient satisfaction is important, I've voiced concern in the past about giving hospitals a financial incentive to cater to patient surveys.In a previous USA Today column, I wrote, "already, more than 80% of doctors ... said patient pressure influenced their medical decisions. And in primary care, ...
Why CMS should settle with primary care plaintiffs
By mid-November, the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) must respond to the legal complaint filed in a Maryland federal court by six Augusta, Georgia family physicians.These doctors are not asking for money, but for relief from the negative effects brought about by CMS’ twenty year reliance on the American Medical Association’s Relative Value Scale Update Committee (RUC) ...
Why hospitals and physicians should get serious about patient-centered care
Health care professionals are a cynical lot. We joke about the "fad or buzzword of the month," usually some vague concept heralded by the powers on high. Our job is to promote the idea, knowing full well that the "next big thing" is probably right around the corner.Take "patient-centered." It sure feels like a buzz word. I suspect most hospital and physician executives, and their ad agency partners, ...
AMA: Act quickly on Medicare deadlines
A guest column by the American Medical Association, exclusive to KevinMD.com.There are several upcoming deadlines that are critical to physicians who care for Medicare patients. November 1, November 23 and January 1 are dates that should be marked on all of our calendars.The deadline for physicians to apply for a hardship exemption in order to avoid the 2012 Medicare ePrescribing ...
Palliative care physicians can enhance patient decision making
Data from the Dartmouth Atlas show patients with chronic illness in their last two years of life account for about 32 percent of total Medicare spending, with much of that expense going toward physician and hospital fees associated with repeated hospitalizations.Opportunities to reduce medical expenditures during the last 2 years of life are often looked upon as a way to reduce the cost of healthcare while actually improving the ...
The impact of hiding medication costs from patients
Always covered by an employer health plan, I had never given a thought to prescription costs – my medications had been covered by moderate copays. This changed when I retired and enrolled in Medicare (and a Medicare Part D plan).Just prior to retirement, my eyes suddenly began tear and swell so much that it impacted my vision. The eye doctor diagnosed an allergic reaction and prescribed prednisone drops to ...
Should Medicare pay for procedures that have no proven benefit?
"Doctors, with the consent of their patients, should be free to provide whatever care they agree is appropriate. But when the procedure arising from that judgment, however well intentioned, is not supported by evidence, the nation’s taxpayers should have no obligation to pay for it."So argues Dr. Rita Redberg, a cardiologist and professor of medicine at the University of California, in a provocative op-ed published in the New ...
Primary care gets caught in the physician pay crossfire
Major journals have slipped in another article that apparently was designed for controversy and for widespread distribution to media outlets. The New York Times rapidly picked it up. As the nation enters the final months before 29.5% fee cuts for Medicare physician services, there will be many more of these that reach the light of day - too many if this is an indication.What is common to major journals, media ...
Targeting physician salaries is a poor strategy for health care costs
A recent study from Health Affairs took aim at physician salaries.Well, not exactly their salaries, but fees. It's a subtle difference, but that nuance is lost in the mainstream media narrative.According to the study, "American primary care and orthopedic physicians are paid more for each service than are their counterparts in Australia, Canada, France, Germany and the United ...
Human capital makes doctors special
If you’ve ever been sick, especially with anything serious, you quickly realize that doctors, nurses and their ilk are an unusual and precious resource.First you have to find smart people with personalities willing and able to put up with a lot of guff in the service of their fellow man. Then they have to be willing to (usually borrow, and) spend tens or hundreds of thousands of dollars for ...
Government austerity with Medicare reform as a top priority
Medicare needs to be reformed, but there's no easy solution to the problem. As the average life expectancy increases, more-and-more politicians have proposed an increase in the Medicare eligibility age. This increase in life expectancy, however, is an issue that only affects the wealthiest half of America -- the people that need Medicare the least -- because the life expectancy has only increased significantly in the richest half of ...
Medicare patients should bring a companion to office visits
When a patient shows up for a doctor’s appointment with a companion, I often find myself studying (and later, interacting with) them as much as I do the patient. Most times, a quick review of body language is all I need to make an assessment – is this person looking out for the interests of the patient? Are they here begrudgingly, or out of concern? Are they indifferent, or ...
How Medicare undermines primary care
When I was a family medicine intern, I met a diabetic patient in the hospital who had stopped seeing his regular doctor after he lost his job and his health insurance. His untreated diabetes made his feet go numb. He stepped on a nail and didn't realize it until he noticed a smell that cost him his foot.He spent thousands of dollars on the surgery and subsequent hospital stay—far ...
