The temporary course to freeze the scheduled 21% medicare reduction was blocked by Republican Sen. Jim Bunning of KY. Bunning claims the fix in the bill would add to the national debt.

Physicians and patients alike are outraged. This new cut will devastate the physician community and put disabled and elderly patients at risk of losing care.

So what is it going to be? Are you going to continue to accept medicare? Can you afford to accept a 21% pay cut?

Some or all information contained above compliments of Desiree Baylin at www.POMAA.net

Check out the observations made by doctors around the country and give us your take:

“If it’s necessary to respond to guidelines rather than what you see, feel and hear when you’re evaluating a person, then perhaps you’re going to do something that isn’t really the right thing.”

“We’re the bad guys now because we help people live to 85. So now we’re trying to change healthcare because people are living too long.”

“When you have an illness and you want an accurate diagnosis and treatment, you want a specialist, not a GP”

“Government is in the process of duplicating everything that managed care did for the last 15 years that was reviled by everybody.”

“We are now being told that we take the Hippocratic Oath too seriously.” (all quote come from Betsy McCaughey, Wall Street Journal, OpEd, Nov 6, 2009)

What do you think?

 

Obama directs all federal agencies to intensify claims review in a fraud-fighting effort. A separate proposal for physicians to pose as patients prompts AMA concerns.

Washington -- The use of auditors who pore over physician Medicare claims -- as well as bills from other government contractors -- to identify and recover past overpayments will be expanded under the Obama administration's latest crackdown on fraud, waste and abuse.

The president on March 10 announced a new effort to improve federal payment accountability through the use of payment recapture audits. An executive memorandum directs the White House Office of Management and Budget to develop guidance within 90 days on actions agencies across the government should take to expand the use of these reviews.

Healthcare Reform has passed but it will be a long time before the experts figure out the many ways that physicians will be affected. Predictions are that taxes and premiums will increase, doctors will be forced to consolidate and the health care system will become two tiered. Here is our summary of the “first wave” of opinions that are coming from our contact with physicians and with key experts in the field.

What Will the Effects be on Insurance Markets?

The Shake-up has started and the word inside the insurance industry is that the major players are in high gear to reposition so that they will be the beneficiaries of the healthcare bill. With 30 million new patients coming on board, there is real opportunity for the carriers.

The large hikes in small group premiums are expected and in anticipation of the new changes; carriers are expected to make large hikes as soon as they can to establish a new baseline for the future

Carriers will consolidate as many carriers find that their health insurance lines of business are not as profitable they will drop out or consolidate.

Effects on Doctors

There will be more uncertainty. Nobody knows the extent of the impact on physicians. Healthcare is not officially a political football and will take many twists and turns over the years, leaving doctors in a difficult position to prepare for the future

Fees will decline and because the money has to come from somewhere, it will come out of doctors and hospitals.

Doctors will possess less bargaining power. As the number of carriers decline through consolidation, physicians will have less power to negotiate higher rates

There will be an increase in “red tape”. New rules will require more expensive staffing and documentation by doctors. The threat of fines from documentation infractions will push physicians to increase their practice infrastructure.

There will be consolidation into larger physician practices. Many physicians who seek to remain independent will come together into larger practices to save on overhead.

Doctors will have to join forces with Hospitals. In rural areas, many providers will be bought out by hospitals or join some sort of sharing arrangement. These are likely to be short lived since hospital profits will be under extreme pressure.

Physicians will “opt out” of the system and go all or partial cash. Many physicians have already positioned their practice for this model. New models for cash revenue are emerging daily and will be integrated into the system.

Doctors will have a difficult choice to make between staying independent or becoming an employee: As many practices falter, doctors will be tempted to “sell” their practice and become employed by clinics, hospitals, academia, the government, and other consolidation models that develop.

Effects on Patients

Longer scheduling and wait times will occur because the system will have difficulty absorbing 30 million new patients. Making it increasingly difficult will cause physicians dropping out of the “public system”.

More choice between insured services and cash services

We expect a cash healthcare system to emerge, a sort of two-tier medical system. One, where the patient has long waiting periods and lower levels of patient care and the other, where the patient pays cash to get the level of care they want.

Premiums will go up as new rules take effect. Large increases are expected to take hold in the next year as the carriers reposition themselves. The requirement to take all comers will guarantee an increase in insurance premiums.

Effects on Small Business

Premiums will go up because small business will be hit with substantial increases near term and will continue to rise as the system evolves.

Taxes will go up along with premiums because employers will have more difficulty in making profits and likely will be less generous to employees.

Benefits to employees will go down with price increases and additional mandates, employers will do the “least” they are required to do.

 

COMMENTS:

I sick of all these negative email-blasts. Post something positive for a change.
Dr. Scott
03/31/2010

WAKE UP AND SMELL THE COFFE. THIS SUCKS. LOOK AT THE LONG TERM, HOW THIS WILL AFFECT EVERY HUMAN.
MICHELLE
03/31/2010

NOT IN A GOOD WAY.
MICHELLE
03/31/2010

Well, that just makes my day….I just thought it may be bad, but you make me sure. What the heck were “they” thinking? Vote the bums out and lets begin a repeal!
Linda Seim, DC
03/31/2010

 
There is some diverse opinions here! Let me start by saying: This particular blog was a result of multiple interviews with DOCTORS. If you want to see somthing positive here… POST IT We want to hear from EVERYONE! HC Reform has passed. We are not here to fight with physicians, we are here to help our physicians’ transition and succeed in healthcare reform with a proactive approach to the vision of medicine.
Sherry L. Krueger
03/312010

I am orchestrating a series of articles, white papers, and webinares that will be of interest to the Physician Community as a whole. If any of you are interested in getting on the interview list please contact me at This e-mail address is being protected from spambots. You need JavaScript enabled to view it
Sherry L. Krueger
03/31/2010

Over the past 30 years I have seen lots of change. Some for the good and some for the not so good. I still remember OSHA rules. Oh g-d what are we going to do . This is terrible. I then took a step back and looked for the positive and I found it . Better sterilization of instruction. Better rules for infections control. Just plain all around procedure that we developed.
So what are we going to do about the health care system. Service our patients find out what services they need and want and give them to them. I have been on to always look for services that were needed and were self pay which give us control over cost and profit.
Maybe it time to ask your patients what they want after It really an honor and privilege to treat patient, because without them you really don’t have a practice. Think about this !!
David Zuckerman DPM
04/02/2010

Self pay (Cash Patients) is trending up and I agree with Dr. Zuckerman. Smart doctors are getting in the stream os self pay patients through marketing efforts and additional uncoded services. Its important to get in the game now!
Sherry Krueger
04/05/2010

This is such a great resource that you are providing and you give it away for free. I enjoy seeing websites that understand the value of providing a prime resource for free. I truly loved reading your post. Thanks!
Medical Jobs
05/08/2010

What a great resource!
Certified Pharmacy Technician
05/09/2010

My cousin recommended this blog and she was totally right keep up the fantastic work!
CNA Training
05/14/2010

 

Many observers of the healthcare reform debate have been under the impression that the government and insurance carriers were on opposing sides. Not so! When it was all said and done, the insurance carriers in America and the United States government have joined forces to become the largest insurer of healthcare in the history of the world. The insurance carriers got thirty million new subscribers as their part of the deal and the Democrats got their wish of universal coverage and regulatory control over the insurance carriers. As one commentator described, “ the insurance carriers really are now claim processors for the government. They are virtually guaranteed to make a profit and all they have to do is play by the rules that the government sets up.”

What does this mean for doctors? Probably not as bad as the public option would have been, but pretty darn close. Remember, the current system is bankrupt. Whether or not you thought that universal coverage was a moral issue, it still is a fact that the system is bankrupt. It is almost a certainty that physician fees will decline (where else does the money come from to insure 30 million people), red tape and regulation will go up making it more expensive to operate a physician practice and last, but not least, physician taxes will increase to pay for all of this. It’s a three way hit for physicians.

 

COMMENTS:

 

Very concerning. We are a middle sized practice and I see a lot of trouble ahead. Quality of healthcare and availability of healthcare are going to suffer and the American people thought that was exactly what this was supposed to help or “make better”. Now what?
Linda
03/25/2010

 
When physicians close their practices and young people stop enrolling in medical school, that will get the government’s attention. Unfortunately, it will take several years for that to happen. In the meantime, physicians will have to work harder to make less money, downsize personnel, and reduce overhead expense. The American people are not going to like the result of that as we are a “I want it now” society.
Annette
03/25/2010

 
Things look bad but what can we do. This is the only profession that does not have any control over how much money you can make. We cannot control fees and our reimbursements are going down, down and further down. There is little motivation to give good service. In the future offices will be swamped with patients but the doctors will make less money. We still have overhead to pay and to keep our income level we will have to see more patients. This is a formula for poor quality care.
Ray
03/27/2010

 
Thank you for keeping us informed. We will be relying on companies like HNA to keep us informed and up to date as all of these changes start taking place. We are a single doctor practice, struggling through the years to keep afloat so the smallest changes often have a great impact on us.
LAVONNA

03/31/2010

 
I agree that we live in an “I want it now society” And this may actually help medical practices. There are many programs and ideas available that can turn a low riembursment rate patient into a cash service patient. Thus using the insurance company as a marketing tool instead of as a means of survival. I have several programs (some free or with free trials) already contracted for this. Email me if you want information at This e-mail address is being protected from spambots. You need JavaScript enabled to view it
Sherry Krueger
03/31/2010

 
I have actually been interviewing writers for weeks now and my biggest hurdle is that AL of them seem to write on behalf of a patient (as that is how they relate). It was a very eye opening experience how few people REALLY understand the plight of the physician. Lavonna, I would like to say a very special THANK YOU to you. You have made our whole day! Sometimes we feel just as beat up and it really warms our hearts that you recognize that EVRYTHING we do is on behalf of our physicians.
Sherry Krueger
03/31/2010

Everything seems to be going against physicians these days. Reimbursements are declining, most expect healthcare reform to hurt doctors more than help them. Doctors lives are increasingly controlled by managed care “specialists”; even worse, the public perception of the integrity of physicians is declining. What should you do, roll over and cash it in. Not so fast….change can be your friend, your best opportunity to move in a new direction.

Think of this. The world is in chaos (I think we all agree on this one!), chaos creates need; need spurs the need for solution. That’s where doctors can come in. You are on the forefront of the healthcare system. The public is clamoring for solutions to the healthcare system. Studies show that patients are looking for a new set of services from their doctors, especially the baby boomers who are coming into the high utilization period of their life. They want convenience, better access, internet based healthcare and wellness. These expectations present all kinds of revenue generating opportunities for proactive doctors. Begin to listen to what your patients want and start looking around for what proactive doctors are providing to meet those needs.