Doctors on a Flat Fee for Services

Massachusetts thinks the way to reducing health care costs is to pay the doctors less. This is not a new idea. The folks who put together Obamacrap have the same ideas.

Dr. JudyAnn Bigby, secretary of health and human services, is developing a specific plan for switching to a new cost-conscious payment system that would essentially put providers on a budget for each patient’s care.

The system, called global payments, would require doctors, hospitals, and other providers to band together into groups called accountable care organizations that would split the payments and better coordinate patient care, thereby improving quality.

It may sound good on paper, but what is the downside to this?

Low reimbursement for a "routine" office visit is part of the problem. Even more so if you are a Medicare patient where reimbursements typically run about 30% less than private patients with health insurance pay.

While it is true that some doc's will upcharge by performing additional tests to increase the reimbursement beyond the normal office visit, many of the diagnostic tests are the result of two issues, namely time limits imposed in a "cattle call" office visit and the need for the doctor to protect themselves against frivolous litigation.

Doctors, particularly primary care docs, must see 10 patients per hour to cover their overhead. This "move them in, move them out" approach is one of the problems associated with low reimbursement rates by health insurance companies.

Litigation is rampant. Seems everyone wants to believe the doctor made a mistake and missed a diagnosis. To get retribution they sue. The doctor must be pro-active and counter by running additional, sometimes, redundant or unnecessary tests in order to protect their butt.

Switching to a flat fee won't help either of these problems.

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