Doctors Limiting New Medicare Patients

Disturbing report that affects millions of people who use Medicare

http://video.foxnews.com/#/v/4247645/doctors-limiting-new-medicare-patients/?playlist_id=87937

Many, Many docs don't take medicare or L&I patients.

Nothing new about it.

Why fill a schedule with low paying gub-mit jobs when you can rake in millions from elective private jobs?

The hipocrits oath and all that. But Irie is right. My dentist told me 25 years ago he wouldn't take Medicaid patients. Said he simply couldn't afford them. but he does take six staff to Hawaii every year.

One of my docs closed down a practice because of the payment structure for medicare/medicaid patients. Let's say a procedure costs a doc $100 to perform, considering supplies, staff, overhead, etc, and then Medicare/Medicaid send you a check for $75, or less. How long, working on that kind of math will you eat through your cash?

Much better to be an ER doc for someone else, make the big bucks, and not have the headache of employees, building overhead, etc.

Dogfish:

I used to audit Miedcaid. What you described is NOT how it works. It's a bit more complex than this, but in a nutshell, Medicaid tracks the amount charged by all physicians for a given procedure. Let's say the average of all Drs to set a broken arm is $100. Medicaid would pay $75. you the lesser of what you charge or $75.00

That sounds interesting, but fuked up... I can hire a journeyman tradesman in the Mid west for 15.00 hr. Try to touch one worth a sh!t for less than 25-30.00 an hr here. So the average of the south and NW screws NW doctors and while it leaves the southern doctor fine.. Typical asshattery from the feds.

WRO,

Interesting point if Medicare payments are the same nationwide. Even the federal wage and salary scale has regional differences, usually in the 3-5% range, but 25% for Alaska and Hawaii.

Sg

3-5% will not cover the geographical cost differences from city to city/state to state. Espicially when Rural/urban costs are compared. For Ex If you make 35K in Gay bay, you can have the exact same life style in Mobile Alabama for ~18K a year. Thats a pile more than 3-5% geographical difference.

We had a health care provider one time that used some place in Minnisota for our normal and reasonable charge.

It takes about a year and a half to two years to go broke seeing only Medicare patients. Much faster with Medicaid only.

Very sad. Not much to do with greed, more to do with expenses greater than revenues.

I believe that a civilized society has provisions for the less fortunate. Currently that risk (i.e. financial cost) devolves to the primary care providers, and to the specialists who have what I call a "social ethic."

I havn't worked with Medicaid for 10 years now so it may have changed. But when I did the fee comparisons were based on the geographical area the provider worked in. So, if the 75th percentile for an office visit in Seattle was $50, the Seattle provider got $50. If it was $75 in NY they got $75 in NY.

The problem remains that health care costs are skyrocketing and our ability to pay is not. There is a serious crunch coming no matter what system we use.

[
quote=Jerry Garcia]We had a health care provider one time that used some place in Minnisota for our normal and reasonable charge. [/quote]

I doubt that can be done. The processing centers simply apply the code times the rate for that region. (Every possible procedure has a code, so if the code for a broken arm is 2234 the centers computers calculate payment based on the code and the 75 percentile for that charge in the region where the Dr practices.) Unless he lied about where he lived there is no way what you describe could be of any benefit to the Dr. it wouldn't matter what the Dr. billed.

What the doctors could do to raise payment rates was bill at a very high rate. That would NOT affect the current fee paid but would tend to raise the 75% for future payment cycles.

You might be interested to know that Medicaid is a state /federal partnership. The feds match the states cost at varying rate depending on the per capita income of the state. So more wealthy states get less form the feds and poorer states get more.

Again this is all 10 years old. May be different now. Thank God I don’t need to know this stuff anymore.

I do find it amusing that so many folks are sure the system is all farked up but really have no idea how it works.

My doc told me that WA physicians get less for a procedure than in other states. As such, he can't afford the patients.

He also said that, maybe a decade ago, it cost something like $100 an hour to keep the office open. What with nurses, receptionists, light, rent, and so on. The overhead was pretty steep.

I think now there are 3 physicians in the practice, at least 3 office people, and a couple of nurses/PAs.

Medicine now seems to take a lot of people to deliver the service.

I doubt that can be done. The processing centers simply apply the code times the rate for that region. (Every possible procedure has a code, so if the code for a broken arm is 2234 the centers computers calculate payment based on the code and the 75 percentile for that charge in the region where the Dr practices.) Unless he lied about where he lived there is no way what you describe could be of any benefit to the Dr. it wouldn't matter what the Dr. billed.

What the doctors could do to raise payment rates was bill at a very high rate. That would NOT affect the current fee paid but would tend to raise the 75% for future payment cycles.

You might be interested to know that Medicaid is a state /federal partnership. The feds match the states cost at varying rate depending on the per capita income of the state. So more wealthy states get less form the feds and poorer states get more.

Again this is all 10 years old. May be different now. Thank God I don’t need to know this stuff anymore.

I do find it amusing that so many folks are sure the system is all farked up but really have no idea how it works.
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It wasn't the Dr., it was the HMO, that was about 20 years ago.