By John Ballard
Maggie Mahar has the supporting data.
I'm hoping she puts this in the form of a brochure.
Ya reckon some professional association would sponsor printing it?
Riiiight.
MYTH #1 Physicians have been refusing to take new Medicare patients; many have a hard time making appointments.FACT: Medicare patients report as good or better access than privately insured patients�even to primary care physicians.
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MYTH #2: The bulk of our Medicare dollars are spent on acute care during the final weeks of life.FACT: About 25% of Medicare dollars are spent on patients during the final year of life�not during the final weeks.
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MYTH #3: Medicare reimbursements to physicians have remained flat to down over the past decade.FACT: [F]rom 1998 to 2008 Medicare fee-for-service reimbursements to physicians climbed by 75%. Of course, over the same ten years, the cost to the doctor of providing services also has risen. In some specialties, doctors who are solo practitioners or working with a small group of physicians have watched their real income drop, particularly if they are located in an area where the cost of labor and real estate is high.
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MYTH #4 Medicare has been underpaying hospitals for years. Reimbursements rarely match the cost of actually treating the patients, which is why hospitals must charge private insurers more.FACT: From 1998 to 2008, Medicare fee-for service reimbursements to hospitals for outpatient services climbed by 85%. Payments for inpatient services rose by more than 40%. ...During this time hospitals were treating more patients, but ...reimbursements outstripped growth in the number of patients served. From 1998 to 2008, total outpatient visits rose by just 32% while inpatient admissions crept up by just 12%.
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MYTH #5 If Medicare tries to rein in spending on hospital care, the quality of care will suffer. Most hospitals are already operating on tiny margins. And there just aren�t many ways for hospitals to cut the cost of caring for patients.
FACT: After adjusting for differences in patient mix, wages, outlier (extremely ill) patients, transfer cases, interest expense, the costs of teaching, and the effect of low-income Medicare patients, MedPac researchers have discovered that when hospitals are under financial pressure either because they have fewer patients, a larger share of Medicaid patients�or because private insurers are paying less�some hospitals manage to become more efficient, and turn a profit on Medicare patients.
I came late to this question, but Myth Number One I have to question.
ReplyDeleteSeveral years ago my company worked on a project concerning Medicare in Pennsylvania. I had, and my partners had, a lot of doctors tell us that they were not taking new Medicare patients.
They told us that they were losing money on every Medicare patient; that the reimbursement rates didn't cover their costs. And that was at least 5 years ago.
I don't doubt what you say but check out the stats at the link. I'm just an old guy blogging and certainly neither a statistician nor an expert. Following the health care reform debate now since it started I know for certain that a significant portion of medical pros have a negative view of the Affordable Care Act, Med Pac and anything connected with either. It comes as no surprise that any group of doctors would decide not to take any new Medicare patients. Many established practices, in fact, are not accepting new patients at all, Medicare or not.
ReplyDeleteThe stats cited by Maggie Mahar are based on the patient population, not the medical community. That may account for the contradiction in what doctors report and the actual experience of patients seeking doctors.
Regarding "costs" I have come to the conclusion that doctors and hospitals with superior medical credentials are too frequently not as sharp with their business acumen. For some reason, there are too many places getting outstanding outcomes at lower costs. This snip is from a letter by a retired doctor.
The research performed by the Dartmouth Atlas group has documented that lower cost providers actually offer better care than higher cost providers. The data suggests that if higher cost providers in the Sun Belt and on both coasts were to change their practice patterns to match those of the Mayo Clinic, Cleveland Clinic, and several other large providers, we could not only save significant amounts of money, but would have better health care.
The letter and comments thread are worth a visit.