From Medscape Medical News

Congress Passes Debt Deal; Could Reduce Medicare Payments

Robert Lowes

August 2, 2011 — With a 74 to 26 vote by the Senate today, a contentious Congress finally passed a bill that both shrinks federal spending and raises the $14.3 trillion federal debt ceiling, just in time to beat an August 2 deadline and avert a catastrophic government default.

The House did its part yesterday by approving the bill 269-161 in a grudging bipartisan vote, with Democrats unhappy that envisioned spending cuts topping $2 trillion were not accompanied by any tax increases, which Republicans vehemently opposed. Next comes the expected signature of President Barack Obama, who had crafted the measure with congressional leaders.

The agreement may calm the financial markets by maintaining the credit worthiness of Uncle Sam, but it is troubling physicians and hospital executives, who could see their Medicare reimbursements trimmed in the process. Those potential cuts would come at a time when providers already face other major Medicare reductions. Continue reading →

Lawsuit Targets Medicare Pay ‘Bias’ Toward Specialists

Robert Lowes

August 10, 2011 — Six family physicians in Georgia have accused the Medicare program in a federal lawsuit of illegally relying on a committee of the American Medical Association (AMA), which they hold responsible for paltry reimbursement rates for primary care physicians and inflated ones for proceduralists.

The lawsuit, filed this week in a US district court in Maryland, is the latest sign of a long-standing rift between primary care clinicians and specialists over Medicare compensation. The professional feud has been obscured recently by organized medicine’s united efforts to replace the sustainable growth rate formula that Medicare uses to set physician pay.

Continue reading →

Quality of care need time spend with patients, only works well in the pay for value not pay for volumn healthcare deliverry system.

Article From Medscape Business of Medicine

Rebuttal: Concierge Practice Is a Doctor’s Right

Leslie Kane, MA; Bernard Kaminetsky, MD

Editor’s Note:

Medscape’s recent video commentary by ethicist Arthur Caplan, PhD, “Concierge Practice: Unjust for Patients and Doctors Alike,” provoked a flood of heated responses. To present the contrasting point of view, Medscape interviewed Bernard Kaminetsky, MD, board certified in internal medicine and nephrology.

Dr. Kaminetsky is the Medical Director of MDVIP, a company with a national network of primary care physicians who provide personalized care, focusing on wellness and prevention, and use a concierge-type model. Dr. Kaminetsky was a founding partner in a primary care practice based in Boca Raton, Florida. In 2001, he transitioned his practice to the MDVIP model. He recently left his primary care practice to serve as the national representative for MDVIP. Dr. Kaminetsky has testified before the Joint Economic Committee of the US Congress on the importance of wellness and prevention. He is a graduate of Albert Einstein College of Medicine and a former assistant professor at New York University School of Medicine.

Medscape: In a concierge medical practice, doctors generally charge an annual access fee, have a smaller number of patients, and spend more time with each patient. Some have said that this is unjust or unfair, particularly given the shortage of primary care doctors. How would you respond to that?

Dr. Kaminetsky: Let’s look at it from the patient’s perspective: Is it fair for patients to have an experience — as is common in conventional practice — where visits are very short and doctors are essentially reactive to acute problems because they have very little time for prevention and wellness? And the doctor knowingly is neglecting his or her ability to spend the time necessary with the patient to actually prevent the heart disease or diabetes from forming because there simply isn’t time. Is that fair to patients? Continue reading →

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