Medicare has new rules for doctors

Falling far short of providing financial rewards to doctors for real preventive care, a newly issued 2400 page law goes into effect progressively over the next few years that essentially forces solo practice doctors to join physician groups and adopt electronic medical records.  Doctors who don’t see Medicare patients will be exempt.  [Baltimore Sun]

The plan provides incentives for doctors who provide quality care.  This means proven outcomes.  Up till now, doctors could deliver care without demonstrating positive outcomes.  The big target Medicare has aimed at is reduction of readmission to the hospital.

Frankly, my take is that consumers are more likely to experience a positive outcome by taking their car to a mechanic than taking themselves to the doctor.  In other words, reimbursement schemes pay for treatment, not necessarily for results.

To show you how crazy healthcare financing has become, Medicare recently announced “Accountable Care Organizations” – groups of doctors and hospitals – that coordinated patient care in order to reduce costs, ended up saving Medicare $466 million.  However, Medicare dished out $683 million of bonuses for a net increase in healthcare costs of $217 million. [Investors Business Daily]  The new plan to reimburse doctors, mentioned at the top of this report, will also dish out about $1 billion in bonuses to physicians who provide high quality care.  Under the new reforms, physicians can earn 4% plus or minus reimbursement in 2019, 5% in 2020, 7% in 2021 and 9% in 2022 with reporting starting in January of 2017.  Two years after quality reports are submitted, physicians would be paid these bonuses. [Modern Healthcare]

Under the new rules, doctors would have to monitor their performance on at least 22 measures, an onerous demand for any business.  [Medscape]  Sounds to me like the best doctors will just drop seeing Medicare patients.  An increased number of doctors are expected to retire early. [Forbes.com]

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