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U.S. Medicare reimbursement bill could spell bad news for ME patients!

Discussion in 'General ME/CFS Discussion' started by Horizon, Dec 20, 2016.

  1. Horizon

    Horizon Senior Member

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    I just read an article that is really scaring me because it has passed into law and fundamentally changes the way Medicare will pay doctors. Why should we care how they pay? Well, they now will pay based on results and patients getting better.

    Most of us don't respond to any treatments and have a bad longterm prognosis, are doctors not going to want to deal with patients with complicated medical illness who don't typically improve because they won't get paid?

    Are they going to write in our medical records that we DID improve even though we didn't so that they do get paid which will result in us risking losing our disability status?

    Here is the original article: http://www.nydailynews.com/life-style/healthcare-crisis-medicare-pays-doctors-article-1.2916515 (please someone tell me I am being unnecessarily freaked out!)
     
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  2. Mary

    Mary Senior Member

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    Southern California
    @Horizon - I just tried to read a bit more about this and it is incredibly complex. I can't imagine being a doctor and having to deal with all this bureaucratic red tape! It does look like it potentially could be bad for us, but I don't have the energy to stress about it -

    What comes to mind actually is that most of us are not getting any treatment from doctors for ME/CFS anyways; our regular GPs know nothing about it or don't believe it's real. And the doctors who are knowledgeable I think will keep treating us. It's not that they wouldn't get any compensation but that it might be reduced. I know, a bad thing with an already low Medicare reimbursement rate.

    Again though I can't worry about it because it won't do any good and I don't have the energy to spare worrying about it.

    But thanks for posting this - with the election this just flew under the radar.
     
  3. Groggy Doggy

    Groggy Doggy Senior Member

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    I think that they need give the power to the doctor to decide what treatments are needed to help a patient. Unfortunately, this is not the case, so I don't know how a doctor could be successful in a model that is designed to fail.

    It sounds like they want to fail at a cheaper cost. So yes, I am alarmed, but not surprised.
     
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  4. Horizon

    Horizon Senior Member

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    I think there are so many potential issues with this that it will need to be modified. I think the premise is good in that the doctor should be most concerned with getting their patient better but this doesn't appear to be the right way and could have a lot of unintended consequences.
     
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  5. Groggy Doggy

    Groggy Doggy Senior Member

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    @Horizon Yes, I agree. But if you don't supply adequate resources for doctors to be successful in treating their patients, which is the current model, then reducing the already low fee that doctors earn (assuming we are talking about private practice), will only further discourage doctors in private practice to accept MediCare patients. If you are an existing non-MediCare patient, you can only beg your doctor to accept you as a future MediCare patient. But some doctors may quit and go out of business before you are entitled to MediCare benefits because they currently loose money with the fee structure in place now.
    This is a complex issue on many levels, but basically MediCare is designed to encourage doctors to quit their private practice and join a larger hospital based medical group (where they will certainly loose control regarding treatment options and suffer from a high patient load). This new ruling you detailed will just speed this process up.
     
  6. Nielk

    Nielk

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    That's why many doctors are opting out of Medicare. It just doesn't pay for them.
     
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