Sidenote: In the middle of this article there is an interactive chart that shows how many Medicare recipients live in your state. California leads with 5,601,363.

http://www.lifezette.com/polizette/risk-of-mass-exodus-of-doctors-from-medicare/

MACRA creates two pathways for physician payment. There’s the Merit-Based Incentive Payment System (MIPS), which will pay doctors based on how they score on a number of performance metrics relative to their peers. The second pathway will reward doctors who participate in Alternative Payment Models (APMs) meant to promote high-quality, cost-efficient care by incentivizing doctors to work together toward a common purpose: improving patient outcomes while eliminating unnecessary spending.

This sounds good, but all the emphasis on better quality care comes with a trade-off. To assess the quality of care provided by doctors in the MIPS pathway, the physicians will have to report on a number of measures that many feel do nothing to help them improve the care they provide.

Doctors already devote a considerable amount of time reporting on quality measures. A recent analysis found that a typical medical practice currently spends, on average, 785.2 hours a year per physician to track and report quality measures. That’s time away from patient care, and the costs — $40,069 per physician — present a particular hardship for small, independent practices operating on narrow margins. Moreover, three-quarters of the doctors surveyed felt that the measures did nothing to help them improve their care.

One recent survey of physicians found nearly 40-percent expect a "mass exodus" from Medicare over MACRA.

More at link.

My salesforce was briefed this past spring on what was coming. It isn't going to be pleasant and many doctors are still in the dark about what is coming down the pike.

CMS reimbursement will I predict just get more and more unintelligible and unrealistic over time.
Then, some politician/party will come along with a solution to the healthcare crisis, a single payer system.

It appears inevitable.

Before single payer they will simply mandate that doctors must accept medicare/medicaid patients.  It will be sold as fighting discrimination by doctors against POC's, the elderly, and the poor.  Get found out not accepting your fair share of medicare/medicaid patients?  DEA pulls your prescription writing privileges, your federal student loans become due immediately, and you lose admitting privileges at any hospital that accepts Medicare and/or medicaid.

It's been slow, tedious, and unreliable for years before Obamacare came around.   I can only imagine how much worse it is now.

There is going to be a mass exit by everyone in the healthcare field. Our business is hurting from all of the cuts and they are going to cut another 3.5% this year. This has been going on for the last five years...do the math. Compound interest in reverse.

What we need is more government to save us

And has been the plan from the beginning.  

Fuck with the free market until it sucks, then swoop in and say "see, the market can't handle healthcare!" to push govt control, when it was govt fucking things up from the beginning.

The stories I could tell that would make yalls blood boil if it happened in your field....

not to disagree, but Medicare is the Govt.  Perhaps being that it is broke, they could wash the books with a new program.

You're right, I was just bitching about what they've done in healthcare in general.

But yes, medicare is beyond screwed up.  I have zero faith anything they come up with could be any better.

I'll have a coke.

My Step Dad with a long established GP practice retired early as he saw the writing on the wall.  He even said it would be better to become a Vet than a GP practitioner going forward.





Now that says pretty much all there is to say.





Unregulated, no insurance free market as a veterinarian or
A Internal Medicine practitioner with regulations and malpractice crawling up your ass.





We may die early but our pets will be healthy.




 

A bunch of the doctors near me must be clueless or they think that they make too much because they have Hillary signs out in front of their office buildings.

There are a lot of really smart doctors who know an amazing amount about disease and the human body.....and couldn't tell you a thing worth hearing on politics or any other topic outside of medicine.

We joke about ivory towers with college academics, but it's very much a thing with some doctors too.  I suspect most of the docs with Hillary signs work for a large enough practice or hospital that they don't deal with a lot of the legal/tax issues, only see patients and get a check.

During Obamacare open enrollment next year (November 2017) there will be some areas of the country with no insurance companies providing Obamacare coverage. It will be the "crisis" that allows them to push through a change to Obamacare allowing Medicare to offer coverage in those area. Over the next few years this will spread until Medicare is the single-payer. I expect that when they amend the law to allow Medicare to offer Obamacare plans they will include a clause that forces all doctors to accept those plans.

People will actually be begging for this to happen. Obamacare will have forced the regular insurance plan rates up so high that nobody will be able to afford it. By contrast the new Medicare single-payer plans will be much cheaper because they will be subsidized by taxes, or simply covered by another rise in the debt ceiling.

This ball will be rolling by the 2018 midterms.

Good bye medicare accessibility to mental healthcare.

Who thinks that the mental health providers want reimbursement based on patient satisfaction... hey you want a drug addict or a personality disorder patient to have a say in how much money you get for your services?

I already know many in that profession won't even take insurance.

University of Bangalore and Pakistan University, et al are cranking out MD's as fast as they can print diplomas.

I picture the future of medical care like going to the DMV to renew your driver's license.  You check in at the front with a brief synopsis of your symptoms.  You're assigned a call ticket.  When your number is called, you go to whichever station has whichever practitioner is waiting there for you.  Kinda like in Idiocracy.

Compound interest in reverse absolutely doesnt work lol. But i get the point

still cant force someone to be a doctor. .gov is tarded

You say that but we do have a member here who advocates throwing doctors who don't accept Medicare in jail.  I'm sure he's not the only leftist who has had that thought.