Comments on: The train keeps rolling down the track http://www.medrants.com/archives/2526 Internal medicine, American health care, and especially medical education Sat, 11 Feb 2012 15:15:48 +0000 hourly 1 http://wordpress.org/?v=3.3.1 By: CHenry http://www.medrants.com/archives/2526/comment-page-1#comment-71289 CHenry Sun, 02 Oct 2005 16:17:52 +0000 http://medrants.com/?p=2526#comment-71289 There is a fallacy in thinking that Medicare will always be able to make its market. By imposing a new "metric"--selective P4P, new analysis will have to be done by practices, new procedures to insure performance, all in the hope that the costs of these measures won't exceed their benefits in revenue. If it is a net loser, why play at all? CMMS just doesn't seem to be able to imagine a world where practitioners can tell them to go take a hike. They may be closer to that world than they realize. Costly new digital records, even with "free" V.A. software without payment increases to offset the implementation and maintenance costs of the system--and that will not be "free"--aren't going to get much traction when the reimbursement trend is flat or worse. There is a fallacy in thinking that Medicare will always be able to make its market. By imposing a new “metric”–selective P4P, new analysis will have to be done by practices, new procedures to insure performance, all in the hope that the costs of these measures won’t exceed their benefits in revenue. If it is a net loser, why play at all?

CMMS just doesn’t seem to be able to imagine a world where practitioners can tell them to go take a hike. They may be closer to that world than they realize. Costly new digital records, even with “free” V.A. software without payment increases to offset the implementation and maintenance costs of the system–and that will not be “free”–aren’t going to get much traction when the reimbursement trend is flat or worse.

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