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Bioethics, Health Care Policy, Law, Money and Finance, National, Politics, Public Policy

Medicare meltdown, Obamacare next

Texas Medical Association held our Fall Conference today, and the theme was the “Calendar of DOOM!” I’m afraid they’re right.

(Since the Bastrop fire was only  a few miles east of the Austin location, it’s sort of unfortunate that the slogan was “Don’t be burned!” The graphics showed lava flow and volcanoes, but still!)

Even if “Obamacare” is repealed tomorrow, doctors and patients are facing huge  changes in the next few months. It’s too late to avoid a lot of these changes, unless Medicare rules are overturned completely.

Docs who didn’t use electronic prescribing have until Nov.1 to file with Medicare for an exemption to avoid losing an extra 1% on Medicare payments next year (it’s too late, trust me).

The Centers for Medicare and Medicaid have hired private contractors, called Recovery Audit Contractors (RACs), to review doctors’ notes and billings. The RACs make more money if they find more mistakes in the doctor’s office. Errors will be counted as fraud, and fines will be placed. Docs’ will pay up or have their payments from Medicare held, even though they appeal.

All of us who see Medicare patients face a 29.5 % cut as of January 1, 2011.We’ve faced cuts under the inappropriately named “Sustainable Growth Rate” for Medicare (where the more patients are seen, the less doctors are paid because the total spent wasn’t supposed to increase) (see this explanation), but they’ve always been deferred.  Under the “Super committee” legislation that was created under the law that allowed for that last increase in the National debt level, I wouldn’t be surprised if some of this cut goes though.

Doctors have been very restricted in our ability to invest in labs, hospitals, and medical businesses for years. Next year that will be decreased even more. Bean counters, lawyers, anyone other than a physician may own a hospital.

And then, there’s an HMO/capitated managed care plan that was pushed by President Obama and included in Harry Reid’s midnight move to pass “health reform,” called “Accountable Care Organizations.” (Watch this cartoon.)

The Centers for Medicare and Medicaid published rules yesterday

Remember those examples of ideal hospital systems that President Obama used back when he was selling his healthcare reform?  As soon as the law was passed, and we were able to read it, those systems declined.

During the health care debate, the Mayo Clinic, the Cleveland Clinic, Geisinger Health System and Intermountain Healthcare were repeatedly touted as models for a new health care delivery system.

Now, they have something else in common: All four have declined to apply for the “Pioneer” program tailor-made by the Obama administration to reward such organizations.

while keeping costs down. The ACO provision became one of the most highly anticipated elements of the health care overhaul, and providers embarked on a frenzied race to join in as quickly as possible. (via ‘Poster Boys’ Take A Pass On Pioneer ACO Program – Kaiser Health News.)

Stay healthy, y’all!

About bnuckols

Conservative Christian Family Doctor, promoting conservative news and views. (Hot Air under the right wing!)

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