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Medical Malpractice Reform: Would Doctors Accept The Deal?

The bipartisan debt commission appointed by President Obama recently released its recommendations on how to pare the country’s debt.

Of interest to doctors is the suggestion to change the way doctors are paid. Physician lobbies have been advocating for removal of the Sustainable Growth Rate (SGR) formula — the flawed method by which Medicare, and subsequently private insurers, pays doctors. According to this method, physicians are due for a pay cut of more than 20 percent next month.

According to the commission:

The plan proposes eliminating the SGR in 2015 and replacing it with a “modest reduction” for physicians and other providers. The plan doesn’t elaborate on what constitutes a “modest reduction” in Medicare reimbursement.

Meanwhile, the Centers for Medicare and Medicaid Services (CMS) should establish a new payment system — one that rewards doctors for quality, and includes accountable care organizations and bundling payments by episodes of care, the report said.

The commission also said in order to pay for the SGR reform, medical malpractice lawyers should be paid less, there should be a cap on noneconomic damages in medical malpractice cases, and that comprehensive tort reform should be adopted.

There’s little question that associating physician reimbursements with the number of tests and treatments ordered is a major driver of health costs. Removing that incentive, and better valuing the time doctors spend with patients, is a positive step in the right direction. Read more »

*This blog post was originally published at KevinMD.com*

For Medicare Patients, “The Doctor Is Out”

In a last-minute shocker, the Senate voted Thursday against postponing a scheduled 21-percent cut in Medicare reimbursement to physicians and other healthcare providers. Sixty senators were needed to end filibuster debate and stop the cuts under Senate rules. Fifty six voted in favor, while 40 opposed. There was no Republican support. (And, of course, no support from Senator Lieberman, who is a Republican in disguise.)

Another consequence of the vote is that tens of thousands of Americans who have exhausted their jobless benefits would not be eligible for more. In addition, new taxes on wealthy investment managers would not be imposed, along with an increase in liability taxes on oil companies, leading Democrats to contend that Republicans were protecting Wall Street and the oil industry, according to the New York Times.

“We’re not going to give up,” said Senator Harry Reid, the Nevada Democrat and majority leader. “We know the American people only have us to depend on.” Read more »

*This blog post was originally published at EverythingHealth*

Congress Acts On Doc Fix: Music To Doctors’ Ears

Leading members of the Senate Finance Committee came to an agreement Thursday night on a six-month “doc fix,” paving the way for physicians to be reimbursed a little more for seeing Medicare patients instead of a lot less. (This is now separate from the rest of the legislative package it had been part of, which is still under debate.)

Sen. Majority Leader Harry Reid warned that without passage, there’d be “havoc in America.” But the American Medical Association (AMA) continued its attack on anything less than a permanent solution. The AMA compared it to fiddling while Rome burns. What tune are members of Congress playing?

A) Stayin’ Alive by the Bee Gees
B) Doctor, Doctor! by the Thompson Twins
C) Time to Get Ill by the Beastie Boys

(The Hill, Politico, American Medical Association)

*This blog post was originally published at ACP Internist*

Electronic Medical Records: What Is “Meaningful Use?”

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*

No Doc Fix Vote Before Medicare Reimbursement Cut Kicks In

Senators visited their districts Friday and again today, so the earliest they could vote on the doc fix is tomorrow (6/15) — the day the 21.3 percent reimbursement cut takes effect.

Slowing down the process are the numerous amendments. For example, the duration of the fix is still being negotiated. And there are amendments such as redefining what makes up a rural health district. In California, some rural areas are seeing urban levels of patient demand, but giving more money to these counties is being seen as a kickback akin to others that were proposed during healthcare reform. (Part B News, The Hill)

*This blog post was originally published at ACP Internist*

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