I often hear from physicians that they would do a better job communicating with patients if they were adequately reimbursed for the time it took to do so. Given that certain types of physician-patient communications (patient education, care planning, etc.) can have quantifiable, therapeutic benefits for patients, I can see their point.
I have no problem with physicians asking to be adequately reimbursed for services they provide, as long as they are high quality and add value. For example, teaching chronic disease patients how to care for themselves at home takes time and is critical to effective patient self care. In this role, physicians are called upon to be a provider of necessary information as well as a coach to encourage and support patients.
But as evidence suggests, many physicians don’t communicate effectively enough with patients, chronic or otherwise, to seem to merit additional reimbursement. Read more »
*This blog post was originally published at Mind The Gap*
The Senate has further tweaked its doc fix legislation to restore the extension to six months (from June 1 through Nov. 30) and the pay raise to 2.2 percent, reports a Senate Finance Committee Republican advisor. In Northern Michigan, the doc fix can’t come soon enough, as yet more physicians contemplate not accepting any more Medicare patients. The legislation continues to see revisions in the Senate, following the U.S. House refusal to consider the doc fix as a stand-alone bill. (TwitDoc, WWTV/WWUP-TV News)
But primary care physicians saw a 2.8 percent median compensation increase in 2009, according to a Medical Group Management Association survey. MGMA attributed the rise to employers’ and payers’ increased commitment to primary care, but noted threats to Medicare payments still exist. Read more »
*This blog post was originally published at ACP Internist*
Quiz: What does the term “meaningful use” mean?
A. Using something in a way that gives life purpose and leads to carefree days of glee.
B. It depends on your definition of the word “term.”
C. It’s not mean. It’s really nice.
D. A large number of rules created by the government to assess a practice’s use of electronic medical records (EMRs) so that they can spur adoption, give criteria for incentive rewards, and have physicians in a place where care can be measured.
E. Job security for those making money off of health IT.
The answer, of course, is D and E. Read more »
*This blog post was originally published at Musings of a Distractible Mind*
In a recent blog posting, I described Group Health’s medical home for 8,000 patients. It proved to be a boon for primary care physicians, who were able to reduce the size of their patient panels, see fewer patients per day, refer more patients to specialists, and maintain or increase their incomes.
Patients liked it, too. And Group Health was happy because expenditures per patient were 2 percent lower. But poor patients had trouble getting through the front door of the medical home, so based on demographic differences alone, expenditures should have been lower by 10 percent or more. Nonetheless, they declared victory.
Now news filters south from Ontario’s eight-year experiment with medical homes for 8,000,000 patients, and the news is similar. Participation is skewed to healthier and wealthier patients who, in the absence of risk adjustment, yield profitable capitation for primary care physicians. Incomes have soared an average of 25 percent. Read more »
*This blog post was originally published at PHYSICIANS and HEALTH CARE REFORM Commentaries and Controversies*
“Bold changes are needed in how the United States delivers and pays for primary care if the key goals of national health reform are to be achieved,” according to the health policy journal Health Affairs, which has released a thematic issue devoted entirely to the crisis in primary care.
(The complete articles are available only to subscribers, but Health Affairs’ blog has a good summary.)
I have spent much of the day reading the journal — 47 articles, and a combined 300 pages of text. Here are my “take-home” messages from the articles. Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*