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Title : The Side Yesteryear Side Medicare Md Fee Cut--17 Months, Twenty Days, As Well As Xiii Hours To Go
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The Side Yesteryear Side Medicare Md Fee Cut--17 Months, Twenty Days, As Well As Xiii Hours To Go

The "Medical Home"--A existent Solution?

Now that this year's struggle over Medicare physician fees is all but over, it is of import to plough to existent solutions.

The recent Senate as well as House vote to kill the 10.6% physician fee cutting exclusively defers the occupation for eighteen months.

On Jan 1, 2010, the Medicare physicians are slated to larn an automatic 21% fee cut!

More importantly, the Medicare physician fee structure is grossly out of whack amongst primary attention docs starving nether the electrical flow fee system.

In a recent post, I asked simply what is the solution to this problem? I got a tape publish of replies from docs all along the lines that they are fed upwards amongst beingness underpaid past times Medicare as well as they aren't going to convey it anymore. If they own got to become to a cash human relationship amongst patients for the fees they deserve, or balance bill, as well as then last it.

While their frustration is understandable, these aren't solutions. Collecting $350 upfront from a senior, every bit i doc suggested for a comprehensive visit, isn't progress.

So, nosotros own got eighteen months to simply maintain heading toward the adjacent cliff (this i twice every bit big at 21%), allow the scheme degenerate (cash, residuum bill, or a crisis inward access every bit docs terminate taking patients), or genuinely outset taking roughly constructive steps forward.

It strikes me that the growing give-and-take over the "Medical Home" is a constructive i that nosotros demand to choke on developing. The "Medical Home" isn't a novel fee schedule, it's a new patient human relationship structure that could last the foundation for real physician payment reform. Because the electrical flow fragmentation inward the scheme is at the pump of the problem, I volition propose that it is construction that is to a greater extent than of import than simply fees toward the objective of better toll as well as quality.

In a recent post, I said it was the doctors that own got to take the Pb inward the evolution inward a novel payment scheme for Medicare--and thence the entire scheme since private pay is mostly based on the Medicare structure. The politicians aren't going to produce it until they larn permission from the doctor lobby for a specific plan. As the recent House as well as Senate votes showed, the politicians are afraid of the docs--but non as well as then afraid that they own got been forced to come upwards up amongst a existent solution. The private payers aren't going to produce it because they aren't going to unilaterally prepare something the doctors volition accept.

It is notable that the leading main attention physician organizations--Family Physicians, American College, as well as Osteopaths-- own got gotten out forepart on this idea.

And to the health plans, you lot demand to last encouraging existent solutions because, every bit the recent votes made clear, the adjacent 21% is going to come upwards out of your hides if a existent solution isn't found!

This from Wikipedia on the Medical Home:

Central to the Medical Home approach is the premise that patient-centered care requires a commutation shift inward the human relationship betwixt There Won't Be Any Health Care Reform Without Physician Payment Reform as well as There Won't Be Any Physician Payment Reform Unless the Docs Lead The Way

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