[ARCHIVED THREAD] - Sequester hits doctors (Page 1 of 8)
Posted: 3/2/2013 7:27:42 AM EDT
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2% doesn't seem like much, but a lot of practices (particularly in rural areas, and areas where the payor mix sucks) operate on pretty thin margins. Also, every insurance company out there indexes their payments off of Medicare rates... so EVERY insurance co will end up cutting a similar percentage.
But at least it wasn't the 29% SGR cut they've been putting off for years. Link |
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When about 50% of every healthcare dollar is from the government, medical care as we know it today will be a memory in 5-10-20 years. Fortunately, it can only go so low, and folks stop providing it. We aren't there yet, but that time certainly gets closer. Crappy .gov care with long lines or you will pay out of pocket with after tax dollars to get the care you want now. |
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Only the ones that subsist off the government tit.
http://surgerycenterok.com/ |
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Quit treating medicare/medicaid patients. Explain why to affected patients. Is this not a legitimate option? Unfortunately, the war on independent practice ( think independent contractor) has been effective Many physicians and other non physicians ( like me) who also bill Medicare are employees. I am I take whatever the hospital I work for drags,in. I am an employee. |
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Quit treating medicare/medicaid patients. Explain why to affected patients. +1. Its the only way. Medicare is dropping reimbursement on diabetic test strips to us (retail pharmacy) to 14.62 for a box of test strips. Right now there is not a box from any manufacturer I can buy for that cheap. Its cash or hit the road for them now. |
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Personally, I'm willing to take the 2% cut to stop the ridiculous spending spree Obama is on. It's not even round off error in the budget. The only reason this is remotely a problem is due to the targets for cuts and the late date in the fiscal year. No one in DC is showing the slightest sincerity toward a budget, only to spend more, and then more, to insure their own jobs. |
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Quit treating medicare/medicaid patients. Explain why to affected patients. +1. Its the only way. Medicare is dropping reimbursement on diabetic test strips to us (retail pharmacy) to 14.62 for a box of test strips. Right now there is not a box from any manufacturer I can buy for that cheap. Its cash or hit the road for them now. http://www.amazon.com/TRUEtest-Test-Strips-100-Count/dp/B002CGT09M/ref=sr_1_1?s=hpc&ie=UTF8&qid=1362245308&sr=1-1 There is the problem medical insurance has become a maintenance/welfare program. Major medical policies make sense, but filing insurance from something under $20 is ridiculous, the overhead just to process through the system (pharmacy, doctor's office insurance office etc.) the paperwork is probably hundred's of dollars. |
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Personally, I'm willing to take the 2% cut to stop the ridiculous spending spree Obama is on. No. I don't agree. I already give plenty. PLENTY. Notice how they cut reimbursements to healthcare providers but not limit the amount of care, interventions, number of visits, or medications the patient may receive. That might cost them votes from the FSA. |
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Quit treating medicare/medicaid patients. Explain why to affected patients. One of the problems is that all reimbursements are indexed to Medicare. It is also illegal to take cash payment from a Medicare patient for a service that is normally covered by Medicare. |
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Quit treating medicare/medicaid patients. Explain why to affected patients. So the money we spend on Medicare/Medicaid isn't enough? It is only "enough" to bankrupt the richest country on Earth. Those two things seem to be at odds with each other don't they? Something about this whole situation doesn't add up. The people who get it are saying it is a pittance, but everyone agrees it is so much money that all the citizens combined can't afford to do it. Ever think of it like that? |
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Personally, I'm willing to take the 2% cut to stop the ridiculous spending spree Obama is on. Noble of you, but do you really think this is going to stop the Dems from spending? I'm not arguing against his sentiment. A lot of sacrifice is going to be required to fix our fiscal mess. Problem is, as an ER doc, I'm already required by federal law to take care of anybody/everybody without regard to ability to pay... so right off the bat, my patient census is VERY uninsured/medicaid heavy... we're talking almost 60% of my patient census. The rest is a mixture of medicare and private insurance. So I'm already either being paid a pittance, or not at all... for 60% of my work. Then you look at what I do get paid, and various levels of govt. tax 50% of that away from me. What's that leave for my family? 20-25% of the economic value of the actual work I do? And I'm the problem? I need to sacrifice more? I need to pay more? I want to knock the teeth down the throat of people who say I'm not paying my "fair share"... or that I don't "give" enough... or that I don't "care" enough... or that I'm some evil rich robber-baron who "stole it from the workin' man." Guys like me are the only reason our system isn't already a flaming ruin. |
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Quit treating medicare/medicaid patients. Explain why to affected patients. One of the problems is that all reimbursements are indexed to Medicare. It is also illegal to take cash payment from a Medicare patient for a service that is normally covered by Medicare. This needs emphasis. |
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Quit treating medicare/medicaid patients. Explain why to affected patients. +1. Its the only way. Medicare is dropping reimbursement on diabetic test strips to us (retail pharmacy) to 14.62 for a box of test strips. Right now there is not a box from any manufacturer I can buy for that cheap. Its cash or hit the road for them now. NMO |
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Quoted: Quoted: Quoted: The physicians will just start charging Medicare for an "extended visit" instead of a "brief visit". And then get fined at $10K per incident and/or go to jail for fraud. Unless you manage to find a bunch of unrelated problems. How about a EKG while you're here? I see you haven't had one lately... |
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Physicians will find sources of extra income. This gynecologist was taking videos of his patients, for example. http://baltimore.cbslocal.com/2013/03/01/police-turn-over-evidence-in-hopkins-probe-to-fbi/ |
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What if all the gubmint' employees in management positions were told "Find ways to cut without reducing employment / services" or they would lose their own jobs? I bet everything I'll ever own we would not see any effect from this sequestration. Maybe no more jaunts to Vegas, free meals and all that for the elites but too bad. There is fat that CAN be cut. Watch for the upcoming hearings when a dept cuts services claiming no other option.............
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Yay. I currently get 1/4 of what Medicare pays surgeons (comparing usual & customary dollars billed vs. gov reimbursing). The rates for anesthesia are deplorably low, 16 cents on the dollar.
It is already impossible to sustain an anesthesia practice on government rates. They don't even reimburse enough to cover overhead (malpractice, taxes, misc insurance & other costs). This plays perfectly into the master plan of single payer, socialized medicine that favors midlevel practitioners. Remaining physicians will be marginalized or forced into becoming hospital employees. The days of medicine being a rewarding career, worth the sacrifice of 12 years in training for autonomy and financial security, are ending. I should have been born a decade earlier. Posted Via AR15.Com Mobile |
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There is no "bending the cost curve down.". They're going to save money by providing less care (or paying for less care, yet still expecting doctors and hospitals to provide it) "Value-based purchasing" and fee for performance. They pay a pittance, then set progressively impossible tiers of "quality metrics" that must be achieved to get paid. Posted Via AR15.Com Mobile |
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There is no "bending the cost curve down.". They're going to save money by providing less care (or paying for less care, yet still expecting doctors and hospitals to provide it) "Value-based purchasing" and fee for performance. They pay a pittance, then set progressively impossible tiers of "quality metrics" that must be achieved to get paid. Posted Via AR15.Com Mobile Ding ding ding!!!!!!!! I see your patients temp was a little low getting into recovery room. Less money for you. I see they got an infection. Not paying you. Etc etc. |
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The physicians will just start charging Medicare for an "extended visit" instead of a "brief visit". And then get fined at $10K per incident and/or go to jail for fraud. Unless you manage to find a bunch of unrelated problems. How about a EKG while you're here? I see you haven't had one lately... Which will drive costs up and justify more government takeover. |
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Oh no a historically well paying career will take a 2% hit, what ever will we do! Oh I know..not give a fuck. I don't think you get the big picture. I read his post, and had a vivid mental image of two brain cells, held together with a spirochete. |
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Oh no a historically well paying career will take a 2% hit, what ever will we do! Oh I know..not give a fuck. I don't think you get the big picture. I read his post, and had a vivid mental image of two brain cells, held together with a spirochete. 
Bravo. |
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There is no "bending the cost curve down.". They're going to save money by providing less care (or paying for less care, yet still expecting doctors and hospitals to provide it) "Value-based purchasing" and fee for performance. They pay a pittance, then set progressively impossible tiers of "quality metrics" that must be achieved to get paid. Posted Via AR15.Com Mobile Ding ding ding!!!!!!!! I see your patients temp was a little low getting into recovery room. Less money for you. I see they got an infection. Not paying you. Etc etc. The surgeon made his incision 61 minutes after you gave the antibiotic. If it had been 59 minutes, you would have been good to go. You now fail at antibiotic timing, so we won't pay as much. Better luck next time. |
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Oh no a historically well paying career will take a 2% hit, what ever will we do! Oh I know..not give a fuck. Oh look... a voice of ignorance and class-warfare. *click* He probably thinks oil companies make too much, too. Class warfare works - report profits in terms of dollars, not percentage of gross income. That makes it easier to whitewash - anyone who makes more dollars than you do is greedy. |
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Oh no a historically well paying career will take a 2% hit, what ever will we do! Oh I know..not give a fuck. Oh look... a voice of ignorance and class-warfare. *click* Statist gonna state. How so? I am not a doc and I would love to see gov gone from healthcare. I would wager the docs doubly so. |
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Oh no a historically well paying career will take a 2% hit, what ever will we do! Oh I know..not give a fuck. I don't think you get the big picture. I read his post, and had a vivid mental image of two brain cells, held together with a spirochete. Doc, what you did there. . .I see it. . . 
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Oh no a historically well paying career will take a 2% hit, what ever will we do! Oh I know..not give a fuck. what docs bill and what they get paid are very different. It also affects the doctors employees and all the services that go along with it. medicare pays crap to begin with any way. will affect my wife's business " Biller" her bottom line will get smaller also. |