BAC Medical Marketing
  • Home
  • Who we are ▷
    • Mission statement
    • Meet the team
    • We attract new patients
    • More for less
  • What we do ▷
    • Services offered
    • IdentityFind
    • MEDShield
    • Project samples
  • How we work ▷
    • Workflow process
    • BACMM affiliate program
    • Clients
    • Glossary
  • Why we're different ▷
    • Search engine optimization
    • Case studies
    • Letter from the President
    • Spotlighted products
  • When we're needed ▷
    • Consultancy compensation
    • Marketing tips
    • BACMM Blog
    • FAQs
  • Contact ▷
    • News you can use
    • Testimonials
    • Online resources
    • Jobs at BACMM
Call Today: 800.240.9473

A Solution To Medicare: Doctor-Patient Price Negotiations

9/25/2009

1 Comment

 
Recently, a physician client of BAC Medical Marketing related to me the following story. An elderly woman called him and asked for a medical appointment. She was desperate. He was the ninth doctor she had phoned and nobody was calling her back. What was the problem? When she told him that she had Medicare, he knew what was happening. Increasingly, he is seeing Medicare patients struggling to find doctors and timely appointments.

At its root, Medicare is like any other insurance, except it pays substantially worse. In psychiatry, fees differ according to where you practice. In his area, most people are paid around $160 for a 50-minute session. In 2006, Medicare limited pay to about $115 for that same session. That is a 28 percent discount. The doctors who work most closely with Medicare, those who are “participating” in the plan, are cut even deeper; their fee is reduced by 34 percent.

In order to treat those in need, doctors are often willing to accept such discounts. However, when sustained over a year, the concessions add up. Continuing with the example, assume that a psychiatrist took one hour each week and devoted it to seeing only Medicare patients. Consider this a “weekly Medicare-hour.” For each weekly Medicare-hour, the doctor’s annual income will drop by about $2,070. Doctors who participate in Medicare earn even less; their paycheck is reduced around $2,500. But, that is just one patient a week. Suppose that the psychiatrist has a full practice. In the best case, devoting one eight-hour day a week to treating just Medicare patients will decrease the doctor’s income by about 11 percent.


Though he used psychiatry as the example, the same applies to the other medical specialties. Unfortunately, Medicare is designed to financially discourage doctors from seeing the elderly or disabled. While he believes the vast majority of doctors are not in the field for money, significant pay cuts sting. Thus, it should not surprise us when the old or infirmed cannot find doctors.

Regrettably, the problem goes deeper. Medicare also disrupts the patient-doctor relationship. Although the insurance does a good job in getting treatment to the poor, it interferes in the care of those who are middle income or higher. In my experience, charging an artificially low fee to a well-off patient introduces complex and difficult issues into a treatment.


Imagine seeing a multi-millionaire at a hugely reduced fee. Emotions such as guilt, resentment, entitlement, devaluation or shame can be artificially injected into a treatment. And, resolving such issues is not easy. Medicare physicians must bill at or below the discounted government rate, without exception. Either that or they must refuse to treat the patient. Otherwise, the doctor may be guilty of fraud and face large fines or criminal charges.

More abstractly, this problem is a familiar one to economists. Consider what happens when cities implement rent control. Initially, people are pleased. Then the supply dries up and the existing apartments suffer from inattention and poor maintenance. We are now seeing similar long-term effects in our national health insurance. It suffers from artificially low fees and flawed policies.

How do we solve this problem? Not in the way the government recently acted. Congress agreed to pay doctors about $1.50 more, in exchange for data on his patients. Eventually, Medicare hopes to use the data to create outcome-based punishments and rewards. There is an astounding disconnect here. Congress’s solution solves nothing and just encourages more discontent. Medicare rates are already deeply discounted and the extra dollar is insulting. It will not even cover the costs of complying with the new federal program. Meanwhile, asking for privileged patient data is certain to upset doctors. Congress should be mindful that doctors can always opt out of Medicare, refuse to accept the insurance, and implement a sliding-scale fee structure. Provoke them and an increasing numbers of physicians will avoid Medicare, entirely.

Is there a better solution? Yes. Medicare should continue to set their fees. However, allow doctors to negotiate their own rates. If the doctor and the patient contract to a fee that exceeds Medicare’s, the government should continue to pay what it always has. However, the patient should then pick up the difference. In this way, doctors will again have financial incentives to treat the elderly, the poor will still be subsidized, and the middle class will have increased medical access. Let the patient and doctor negotiate a fair fee, without government meddling. Otherwise, Medicare patients will get increasingly frustrating healthcare with long waits and too few providers.
 
1 Comment

    Author

    Bruce A. Cadkin, MBA President                          BAC Medical Marketing

    Archives

    October 2019
    September 2019
    August 2019
    July 2019
    June 2019
    May 2019
    April 2019
    March 2019
    February 2019
    January 2019
    December 2018
    November 2018
    October 2018
    September 2018
    August 2018
    July 2018
    June 2018
    May 2018
    April 2018
    March 2018
    February 2018
    January 2018
    December 2017
    November 2017
    October 2017
    September 2017
    August 2017
    July 2017
    June 2017
    May 2017
    April 2017
    March 2017
    February 2017
    January 2017
    December 2016
    November 2016
    October 2016
    September 2016
    August 2016
    July 2016
    June 2016
    May 2016
    April 2016
    March 2016
    February 2016
    January 2016
    December 2015
    November 2015
    October 2015
    September 2015
    August 2015
    July 2015
    June 2015
    May 2015
    April 2015
    March 2015
    February 2015
    January 2015
    December 2014
    November 2014
    October 2014
    September 2014
    August 2014
    July 2014
    June 2014
    May 2014
    April 2014
    March 2014
    February 2014
    January 2014
    December 2013
    November 2013
    October 2013
    September 2013
    August 2013
    July 2013
    June 2013
    May 2013
    April 2013
    March 2013
    February 2013
    January 2013
    December 2012
    November 2012
    October 2012
    September 2012
    August 2012
    July 2012
    June 2012
    May 2012
    April 2012
    March 2012
    February 2012
    January 2012
    December 2011
    November 2011
    October 2011
    September 2011
    August 2011
    July 2011
    June 2011
    May 2011
    April 2011
    March 2011
    February 2011
    January 2011
    December 2010
    November 2010
    October 2010
    September 2010
    August 2010
    July 2010
    June 2010
    May 2010
    April 2010
    March 2010
    February 2010
    January 2010
    December 2009
    November 2009
    October 2009
    September 2009
    August 2009
    July 2009
    June 2009
    May 2009

    Categories

    All
    Advertising
    Affiliate Marketing
    Affiliate Program
    Anna Deavere Smith
    Avoiding Malpractice Suits
    Best Practices
    Blogs
    Branding
    Cash Only Medical Practice
    Concierge Medical Practice
    Crisalix Estetix
    Customer Service
    Defensive Medicine
    Dental Practice Marketing
    Developing Physician Leaders
    Electronic Medical Records
    Emwave Products
    Expert Panels
    Facts And Figures
    Gene Smart Wellness
    Going Dutch
    Gum Disease
    Healthcare Reform
    Heartmath
    Holiday Poems
    Ingenio Expert Advice
    Internet Marketing
    In The News
    Let Me Down Easy
    Liveperson Expert Advice
    Managing By The Numbers
    Marketing Momentum
    Marketing Strategies
    Martin Luther King
    Medical Marketing
    Medical Tourism
    Meta Tags
    Mobile Marketing
    Money Driven Medicine
    Most Influential Physicians
    Omega 3 Index
    Online Reviews
    Patient Advocate
    Patrick Soon-Shiong
    Physicians At Funerals
    Practice Advertising
    Prayer Over Treatment
    Pro Football Head Trauma
    Psychographics
    Public Relations
    Referral Marketing
    Search Engine Optimization
    Social Media Marketing
    Solution To Medicare
    Staff Training Programs
    Steve Jobs
    The Art Of Apology
    Top Medical
    Web Site Design
    Web Site Marketing

    Bookmark and Share

    RSS Feed

    Picture

    I'm an expert on Maven!

    Consult with me on Maven



    Zintro Expert
    zintro.com/expert/Marketing-Maven

    Ingenio Expert

    Picture
    Liveperson Expert

    Reuters Insight Expert

    Which of the following changes in your practice most accurately reflect your goal? (Check all that apply) I would like to...
     
    pollcode.com free polls
    YouTube
    Twitter
    Code Of Ethics
    Medical Blog Award
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Dosie Award
    Weblog Award
    AlleyDog Award
    Best Blog Contest Award
    Blogtrepreneur Award
    Top 100 Blog Award
    Blogger's Choice Award
    Blogger's Choice Award
    Blog Advertising - Advertise on blogs with SponsoredReviews.com
Privacy Policy & Cookies Policy -- Terms & Conditions of Use -- Site Map 
                
      BAC Medical Marketing, BACMM and BAC / BACMM logos are trademarks of BAC Medical Marketing.


           © Copyright 2005 - 2019 BAC Medical Marketing. All rights reserved.


Picture

Protected by Copyscape Duplicate Content Detector
Website designed by Black Mamba