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Hoyt

(54,770 posts)

101. There are worse practices too. Doctors aren't always up-to-date, and often treat patients that

Wed Jan 28, 2015, 03:07 PM

Jan 2015

would be better handled by specialists. More importantly, they don't do a very good job of coordinating care.

Here's an example of what folks who specialize in "sick" patients can do to improve/maintain their health status: A 58-year-old with diabetes, heart disease and Parkinson’s, relies on an special case manager to call him every month to check on how he’s doing and help him get the right care from his array of specialists. According to the patient, she’s been very instrumental in pointing him in the right direction and sees her as “a kind of glue” because she saw him as a whole patient.

You can laugh all you want, but our current system needs to focus on outcomes, not the volume of junk performed under a reimbursement system that rewards volume, not outcomes.

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The Obama administration wants to dramatically change how doctors are paid [View all] DonViejo Jan 2015 OP

I have mixed feelings about this. Erich Bloodaxe BSN Jan 2015 #1

My feelings aren't mixed at all. teenagebambam Jan 2015 #2

I agree. What criteria do they use? There are some conditions where patients do not get better in still_one Jan 2015 #76

I'm sure they've already thought of the situations you have cited. CTyankee Jan 2015 #97

You have much more confidence then I do still_one Jan 2015 #100

Try spending 16 years in school. Whatever 840high Jan 2015 #3

As a matter of fact I have. Erich Bloodaxe BSN Jan 2015 #4

Do you help people live healthier and longer? Do 840high Jan 2015 #15

yes. he's a BSN. next question? elehhhhna Jan 2015 #36

This message was self-deleted by its author 840high Jan 2015 #49

Yup. nt Erich Bloodaxe BSN Jan 2015 #85

Given that he seems to be a nurse, I would assume so (nt) Recursion Jan 2015 #93

And all those years in school and the studying of difficult material and then the many years JDPriestly Jan 2015 #55

It takes that long to get a bachelor's degree. candelista Jan 2015 #70

they make more money then you think. even an old school vet I worked for made 3k every 10 pets Sunlei Jan 2015 #72

OF COURSE you do! VanillaRhapsody Jan 2015 #6

Simon and Garfunkel? freshwest Jan 2015 #28

I know right! VanillaRhapsody Jan 2015 #32

See my post # 55. This is a horrible idea. JDPriestly Jan 2015 #56

right because winning.... VanillaRhapsody Jan 2015 #63

I agree with you BrotherIvan Jan 2015 #14

funny how you LLI's are saying this...when that is EXACTLY what they do in Europe! VanillaRhapsody Jan 2015 #31

What is an LLI? BrotherIvan Jan 2015 #50

A "silent" dog whistle....or??? snappyturtle Jan 2015 #77

I'm still waiting to find out BrotherIvan Jan 2015 #83

You make good points. And the devil is in the details. Faryn Balyncd Jan 2015 #23

Some tests are not necessary, as in the case of my father, blood test showed Thinkingabout Jan 2015 #5

Your mother had the option 840high Jan 2015 #17

... madamesilverspurs Jan 2015 #7

It's Medicare, not for-profit insurance. jeff47 Jan 2015 #12

How do you measure value? Not sure about this change. Frustratedlady Jan 2015 #8

I agree, let me explain myself SummerSnow Jan 2015 #9

Why did u stay with this doctor? 840high Jan 2015 #18

i didnt, after 2 visits we switched, but it took about 7 days to switch through the insurance co. SummerSnow Jan 2015 #86

And if one is female, the standard is tell them it's psychomatic, IOW, you are hysterical... freshwest Jan 2015 #33

That reminds me of the Chris Rock Robitussin skit shanti Jan 2015 #88

How will doctors be stopped from "passing the buck"? My Good Babushka Jan 2015 #10

It's Medicare. There's no one to pass the buck to jeff47 Jan 2015 #11

I personally have Blue Cross and medicare. So yes it is for profit and there is someone else LiberalArkie Jan 2015 #20

No, there really isn't. The proposal is for how Medicare pays doctors. jeff47 Jan 2015 #21

Oh, no one will say anything and it will all look very above board My Good Babushka Jan 2015 #62

After all, they are making more than minimum wage--for India Demeter Jan 2015 #13

Possible outcome of this new method of payment HeiressofBickworth Jan 2015 #16

+1,000 CountAllVotes Jan 2015 #19

We do need Medicare for all. area51 Jan 2015 #57

What will happen to the disabled? CountAllVotes Jan 2015 #74

sounds like... mikemcl350 Jan 2015 #96

Fortunately there would be adjustments for baseline status. You'd get more for treating Hoyt Jan 2015 #29

Or drugs they buy from the manufacturers and sell at a mark-up (nt) Recursion Jan 2015 #94

+1000 nt Mojorabbit Jan 2015 #79

Probably not a good analogy zipplewrath Jan 2015 #22

Makes doctors into Igel Jan 2015 #24

That in a nut-shell nolabels Jan 2015 #64

Another terrible idea...did Arne Duncan come up with this? Ka hrnt Jan 2015 #25

^^This!^^ BrotherIvan Jan 2015 #84

I know. God forbid we look at the outcomes of people's work Recursion Jan 2015 #95

Okay. But I think this sounds like education reform with all the testing scores that mean nothing. jwirr Jan 2015 #26

And there would be little motivation for doctors to treat complicated problems pnwmom Jan 2015 #27

Not true. Docs will get paid more for treating sick patients. Hoyt Jan 2015 #30

I would hope so. But as I said - she is never going to get better. She is getting older and we are jwirr Jan 2015 #34

How so? Not if they're rewarded for keeping people healthy. n/t pnwmom Jan 2015 #37

It's relative. Keeping a person with diabetes healthy is more challenging. Hoyt Jan 2015 #39

It's not nearly as simple as you think. Some people are chronically ill and won't pnwmom Jan 2015 #40

So an Endocrinologist is going to start treating runny noses? Hoyt Jan 2015 #41

No, but an endocrinologist might not want to take a patient pnwmom Jan 2015 #43

They will get severity adjusted payments. There are systems available right now to handle that. Hoyt Jan 2015 #44

The Obama administration wants to "dramatically change" how things are done. pnwmom Jan 2015 #45

No doubt, anything Obama proposes is designed to screw us. We have the worst Hoyt Jan 2015 #46

I am not a person who denigrates Obama in general, or the ACA in general. pnwmom Jan 2015 #47

I think if you read up on reimbursement systems that reward outcomes, you'll feel better about it. Hoyt Jan 2015 #48

In France, I had the impression that the doctors were paid on salaries in some cases. JDPriestly Jan 2015 #59

Too complicated. JDPriestly Jan 2015 #58

I think we better worry about how to change the delivery system to improve outcomes, not Hoyt Jan 2015 #61

I think you are asking a very good question that would apply to millions of people, pnwmom Jan 2015 #38

Whenever I read a thread like this I am so happy that cadaverdog Jan 2015 #35

I have them too, and they have been doing what Obama is proposing for decades. Hoyt Jan 2015 #42

when you say make copies of everything Skittles Jan 2015 #52

You will need various documents from your employer and your union, cadaverdog Jan 2015 #75

Like educational reform goes healthcare. BadgerKid Jan 2015 #51

More of O's micro-managing/means testing, but this time, targeting doctors instead of public schools blkmusclmachine Jan 2015 #53

Ah, but it looks good to tinker around the edges of a problem rather than Nay Jan 2015 #65

Nope Blackjackdavey Jan 2015 #68

An ice floe would kinder and more honest. "Sick" and poor Medicare patients will not be able McCamy Taylor Jan 2015 #54

this isn't going to help.Doctors already cherry pick who they will diagnose Herself Jan 2015 #60

Everyone is doing it! Blackjackdavey Jan 2015 #66

How about focusing those standards on the Pharma Industry instead? FLPanhandle Jan 2015 #67

This Can Be a Blessing And/Or cynzke Jan 2015 #69

an excellent idea-many who are on Medicare and Medicaid do NOT receive the best care Sunlei Jan 2015 #71

i think it is about time we used all the data locked up in the medicare system. mopinko Jan 2015 #73

As a Physician Assistant practicing clinical medicine in the primary care setting, Aristus Jan 2015 #78

My husband was a physician Mojorabbit Jan 2015 #81

Undoubtedly. There are so many variables in the practice of medicine that there can't be Aristus Jan 2015 #82

So This Would Mean RobinA Jan 2015 #80

Somebody who wants to help folks and/or make $200+K a year, all but guaranteed. Hoyt Jan 2015 #87

Are you in the medical field? Mojorabbit Jan 2015 #89

There are definitely "best practices" for most situations. Unfortunately, some docs don't Hoyt Jan 2015 #90

I guess it is what lens you see through Mojorabbit Jan 2015 #91

Agree. I pretty much judge docs by if they accept Medicaid. Today, most don't. Hoyt Jan 2015 #92

"Best Practices" RobinA Jan 2015 #98

There are worse practices too. Doctors aren't always up-to-date, and often treat patients that Hoyt Jan 2015 #101

Is this proposal as simplistic as that? CTyankee Jan 2015 #99

Medicine is already halfway there Mojorabbit Jan 2015 #102

It is in the best interests of the insurance companies to make a profit. CTyankee Jan 2015 #103

like so many great ideas, there are unintended consequences fxstc Jan 2015 #104