Medicare System Overhaul proposed

There’s a new (proposed) system in our nation, and this version includes sweeping changes in Medicare in order to reward and penalize various health care providers and organizations based on quality of care. Two bipartisan leading senators, Max Baucus (D-Mont.) and Charles E. Grassley (R-Iowa), believe the overhaul of the current system would create financial incentives for providers to coordinate care that is currently fragmented. Some of the components include recommendations to slow the growth of Medicare, hold doctors and hospitals more accountable, and to improve the quality of care of patients with chronic illnesses.

 

A five percent bonus would be received by family doctors and internists for Medicare patients for office visits and some “primary care services”. General surgeons in rural areas would also receive bonuses; Medicare payments to other specialists would probably be reduced. Some other components include the following proposals:

·         increasing Medicare payments to doctors exceeding ‘national standards’ of quality care (and penalties to those who do not meet minimum federal standards).

·         awarding bonuses to facilities or hospitals that provide superior care for certain selected other conditions like heart attacks and pneumonia.

·         physicians will also be encouraged to hire nurses for follow-up care once patients are discharged from the hospital disease relating to their chronic illness.

 

Generally we like the creative thinking though we would want to make sure that doctors didn’t become motivated to avoid patients with diabetes who need more care than average; we are also curious whether payments to specialists who care for people with diabetes would be reduced – that would definitely not be in all our collective best interests.

 

Comments

[Mandy]

When standards for quality care are being imposed, it can have negative impacts to patients too. If you are an endo, and you have a few elderly patients who have complications, or a significant risk of not feeling a low, it becomes more dangerous to strive for the lower A1c. Does the doctor endanger the patients with an imposed standard, or give the best individual care and risk the rating of his practice.

Most answers to health care reform are not black and white.