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Old January 26th, 2015, 04:26 PM   #1
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SMART: Quality over Quantity

MEMO TO REPUBLICANS: This is what governing looks like;

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The Obama administration wants to dramatically change how doctors are paid

Source: Washington Post

The Obama administration on Monday announced an ambitious goal to overhaul the way doctors are paid, tying their fees more closely to the quality of care rather than the quantity.

Rather than pay more money to Medicare doctors simply for every procedure they perform, the government will also evaluate whether patients are healthier, among other measures. The goal is for half of all Medicare payments to be handled this way by 2018.

Monday’s announcement marks the administration’s biggest effort yet to shape how doctors are compensated across the health-care system. As the country's largest payer of health-care services, Medicare influences medical care generally, meaning the changes being initiated by the administration will likely be felt in doctor's offices and hospitals across the country.

“As a very large payer in the system, we believe we have a responsibility to lead," said Health and Human Services Secretary Sylvia Mathews Burwell in a press conference. "For the first time, we’re going to set clear goals and establish a clear timeline for moving from volume to value in the Medicare system.”

Read more: The Obama administration wants to dramatically change how doctors are paid - The Washington Post
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Old January 26th, 2015, 05:41 PM   #2
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So, we should expect even more doctors retiring? The government will evaluate whether patients are healthier? So, if a patient will not get better no matter what a doctor can do, they doctor will not get paid for the procedures?
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Old January 26th, 2015, 05:41 PM   #3
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Private insurers just raise premiums to pay doctors. Medicare is going to clamp down doctors padding their bank accounts with unnecessary testing.
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Old January 26th, 2015, 06:00 PM   #4
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Death panels by any other name are still death panels.


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Old January 26th, 2015, 06:08 PM   #5
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No, it looks like the days of a doctor seeing a Medicare card and sporting a woody might be in trouble. Coming down hard on corruption will be lifesaving.
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Old January 26th, 2015, 06:31 PM   #6
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Originally Posted by Camelot View Post
Private insurers just raise premiums to pay doctors. Medicare is going to clamp down doctors padding their bank accounts with unnecessary testing.
Don't tell anyone but doctors are not paid for the testing they perform..

It's a secret... ... ... Everyone seems to know this but you.... actually the more testing they do, unless it meets medical necessity they are NOT reimbursed.


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USA (Medicare)[edit]

Medicare pays for medical items and services that are "reasonable and necessary" for a variety of purposes. By statute, Medicare may only pay for items and services that are "reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member", unless there is another statutory authorization for payment.[1]
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Old January 26th, 2015, 06:36 PM   #7
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Originally Posted by Camelot View Post
No, it looks like the days of a doctor seeing a Medicare card and sporting a woody might be in trouble. Coming down hard on corruption will be lifesaving.
Why don't you post the Medicare payment rates compared to cash or insurance payment rates so we can see how profitable Medicare is for doctors. And explain how receiving a Medicare payment is corruption.
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Last edited by Jimmyb; January 26th, 2015 at 06:47 PM.
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Old January 26th, 2015, 07:04 PM   #8
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The concept of paying for quality vs quantity is a very attractive proposition. It has been studied here for ages. And there is still no equitable way to do that as far as the experts can determine.

I'm an old fart. I finally found a doctor that essentially specializes in old farts. In the same clinic is a guy that specializes in athletes. Guess what, my guy is going to have a far higher croaking rate than the other guy. So I guess he gets less money, right?

That's a simplistic example of the problem but part of a very real one. The concept is so appealing but how to accomplish it is the problem.
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Old January 26th, 2015, 07:13 PM   #9
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Originally Posted by RNG View Post
The concept of paying for quality vs quantity is a very attractive proposition. It has been studied here for ages. And there is still no equitable way to do that as far as the experts can determine.

I'm an old fart. I finally found a doctor that essentially specializes in old farts. In the same clinic is a guy that specializes in athletes. Guess what, my guy is going to have a far higher croaking rate than the other guy. So I guess he gets less money, right?

That's a simplistic example of the problem but part of a very real one. The concept is so appealing but how to accomplish it is the problem.
In the U.S. RNG, doctors have an ownership interest in imagery machines and other devices. They also receive compensation from pharmaceutical companies. Therefore, their motivation is about quantity over quality. I posted an article a couple of months ago explaining how a health network required their doctors to meet a quota for Medicare admissions regardless of necessity. The doctors banded together and pushed back on such quotas. The were summarily fired. Medicare abuse in our hospitals is scandalous.
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Old January 26th, 2015, 07:14 PM   #10
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Originally Posted by Camelot View Post
In the U.S. RNG, doctors have an ownership interest in imagery machines and other devices. They also receive compensation from pharmaceutical companies. Therefore, their motivation is about quantity over quality. I posted an article a couple of months ago explaining how a health network required their doctors to meet a quota for Medicare admissions regardless of necessity. The doctors banded together and pushed back on such quotas. The were summarily fired. Medicare abuse in our hospitals is scandalous.
WRONG again.. Doctors cannot refer testing to laboratories or centers in which they have a vested interest.

It violates conflict of interest laws.

Last edited by TNVolunteer73; January 26th, 2015 at 07:18 PM.
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