Saving Medicare

CMS (Center for Medicare Services) has a great idea for saving Medicare. Cut doctor pay by 30%. Yeah, that will work. Who isn’t in favor of a pay cut? Take one for the team and all that.

MedPageToday reports that in addition to a 30% pay cut the following are being considered:

• Expanding the “multiple procedure payment reduction” to include interpretation of advance imaging procedures, “to recognize the overlapping activities that go into valuing these services.”
• Releasing criteria for a health risk assessment that can be done during the annual wellness visits now covered by Medicare. “This proposal is intended to support a systematic approach to patient wellness and to provide the basis for a personalized prevention plan,” CMS noted.
• Adding smoking cessation services to the list of covered telehealth services.
• Beginning to establish a new “value-based modifier” to reward doctors for providing higher quality, more efficient care. The modifier would debut in 2015 and be used only for certain physicians and physician groups, but would be extended to include all physicians by Jan. 1, 2017. This year’s rule includes proposed quality and cost measures that would be included in the modifier

Short explanation is they hope to reduce redundancies in patient care which is not a bad thing with the following exception. In an attempt to reduce medical malpractice claims, doctors routinely order more tests than are necessary. If redundant tests are eliminated it is possible malpractice claims may increase which in turn will require the doctor to charge more for services rendered.

It appears Medicare will cover fewer items under preventive care than were granted under Obamacare and will also suggest changes to reduce one on one face time with the doc and replace it with a phone consult instead.

While accountability is a good thing it fails to account for medical providers who treat the most seriously ill patients. It also begs the question about the degree of care patients will receive under the “value-based modifier”.

Will a physician be alloted a “bucket of money” for a condition and when those funds are exhausted is your care also finished? “No, you are not cured and I am sorry you are still in pain but Medicare expects me to treat you for free and that is something I am not willing to do”.

Regardless of what Medicare does, the key to hanging on to more of your money is having the right Medicare supplement plan. Georgia Medicare Plans offers the most affordable Medigap plans in the state.