Comments on: Universal health care will require fair pay for primary care http://www.medrants.com/archives/4198 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: Steve Levine http://www.medrants.com/archives/4198/comment-page-1#comment-526262 Steve Levine Thu, 23 Apr 2009 19:16:50 +0000 http://www.medrants.com/?p=4198#comment-526262 With coverage in the New York Times and Wall Street Journal recently, the Texas Medical Association’s survey of primary care physicians’ reluctance to take new Medicare patients is getting lots of play. Certainly the economic and administrative hassle factors are there and make a big impact on physicians trying to keep open their practice. What has been omitted, though, is the other major finding from our survey: Texas physicians will not refuse their current Medicare patients. Nearly 70 percent say that is something they will not do. Fewer than five percent say that is something they have done or will do. As a family medicine specialist from Dallas said in response to our survey: “I will continue to provide care to my existing Medicare patients as a courtesy to them, but I will soon be closing my panel to new Medicare patients, because not doing so will jeopardize my ability to provide care to everyone else.” http://tinyurl.com/6de3pl Steve Levine VP, Communication Texas Medical Association With coverage in the New York Times and Wall Street Journal recently, the Texas Medical Association’s survey of primary care physicians’ reluctance to take new Medicare patients is getting lots of play. Certainly the economic and administrative hassle factors are there and make a big impact on physicians trying to keep open their practice.

What has been omitted, though, is the other major finding from our survey: Texas physicians will not refuse their current Medicare patients. Nearly 70 percent say that is something they will not do. Fewer than five percent say that is something they have done or will do.

As a family medicine specialist from Dallas said in response to our survey: “I will continue to provide care to my existing Medicare patients as a courtesy to them, but I will soon be closing my panel to new Medicare patients, because not doing so will jeopardize my ability to provide care to everyone else.”

http://tinyurl.com/6de3pl

Steve Levine
VP, Communication
Texas Medical Association

]]> By: country solo doctor http://www.medrants.com/archives/4198/comment-page-1#comment-526224 country solo doctor Tue, 21 Apr 2009 12:11:18 +0000 http://www.medrants.com/?p=4198#comment-526224 Likely with univervsal health care the total pie will be the same. Currently the pie divided unequally among primary and specialty care. My primary care 12 hour days are worth less and my knowledge is less valuable compared to the same 12 hours spent each specialist. Medicare has the same total funding, but larger pieces of the pie go to procedures and specialty testing. It does not seem to matter that the specialists send their patients back to the primary care physician to manage dozens of medications and treatment plans. The private plans seem to base their fees on Medicare or less, and it is a take it or leave it attitude with poor out of network coverage. A note about the $300 procedure above, Medicare has a limiting charge, even for out of network physicians, which is why the fee schedule has a limiting charge. An exception is for a procedure that is not medically necessary or that Medicare is unlikely to cover, which means an advanced beneficiary notice needs to be signed. Likely with univervsal health care the total pie will be the same. Currently the pie divided unequally among primary and specialty care. My primary care 12 hour days are worth less and my knowledge is less valuable compared to the same 12 hours spent each specialist. Medicare has the same total funding, but larger pieces of the pie go to procedures and specialty testing. It does not seem to matter that the specialists send their patients back to the primary care physician to manage dozens of medications and treatment plans.
The private plans seem to base their fees on Medicare or less, and it is a take it or leave it attitude with poor out of network coverage.
A note about the $300 procedure above, Medicare has a limiting charge, even for out of network physicians, which is why the fee schedule has a limiting charge. An exception is for a procedure that is not medically necessary or that Medicare is unlikely to cover, which means an advanced beneficiary notice needs to be signed.

]]> By: SteveSC http://www.medrants.com/archives/4198/comment-page-1#comment-526215 SteveSC Tue, 21 Apr 2009 01:09:17 +0000 http://www.medrants.com/?p=4198#comment-526215 What is far more likely is that reimbursement will stay low to push more primary care by non-physicians. What is far more likely is that reimbursement will stay low to push more primary care by non-physicians.

]]> By: Dr. Bob (FP) http://www.medrants.com/archives/4198/comment-page-1#comment-526204 Dr. Bob (FP) Mon, 20 Apr 2009 16:24:09 +0000 http://www.medrants.com/?p=4198#comment-526204 One of our problems is that it's illegal for us to organize on some of these things. We can't decide as a group not to see United healthcare or Medicare, but they can easily decide to change our rates with no negotiation. We also get stuck because the patient gets caught in the middle. To Medicare or UHC, a patient is just a number. To me, they're my patients who I've been through a lot with. I don't want them to suffer for payer decisions. Docs who care get stuck between a rock & a hard place. One of our problems is that it’s illegal for us to organize on some of these things. We can’t decide as a group not to see United healthcare or Medicare, but they can easily decide to change our rates with no negotiation. We also get stuck because the patient gets caught in the middle. To Medicare or UHC, a patient is just a number. To me, they’re my patients who I’ve been through a lot with. I don’t want them to suffer for payer decisions. Docs who care get stuck between a rock & a hard place.

]]> By: Matt http://www.medrants.com/archives/4198/comment-page-1#comment-526197 Matt Mon, 20 Apr 2009 13:11:19 +0000 http://www.medrants.com/?p=4198#comment-526197 "I hope that health care reform considers carefully paying appropriately for primary care." This is politics. Hope ain't going to be enough. You physicians better wake up and get organized and bring your considerable financial resources to bear. “I hope that health care reform considers carefully paying appropriately for primary care.”

This is politics. Hope ain’t going to be enough. You physicians better wake up and get organized and bring your considerable financial resources to bear.

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