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| Topic: Mayo Clininc Shuts It's Door To Medicare Patients | |
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Two weeks ago the Mayo Clinic shocked the nation when it closed the doors of one of its Arizona clinics to patients on Medicare. Just this past June President Obama himself praised Mayo as a model of medical efficiency noting that Mayo gives “the highest quality care at costs well below the national norm.” If Mayo feels compelled to walk away from this government-run program, others will surely follow. The nation must understand why.
Doctors are leaving Medicare for two reasons: one obvious, the other more concealed. The first is simple—the math: 1) For the past decade Medicare consistently paid physicians 20% less than traditional insurance companies for identical service. 2) On January 1, 2010 Washington made hidden cuts to Medicare by altering its billing codes. 3) Medicare will cut physician reimbursement by another 21% on March 1. The CBO said this cut must take place if the Senate healthcare bill was to “reduced the deficit.” 4) Even more, Congress pledged to cut Medicare by yet another $500 billion. Again, the CBO said this additional cut must take place if the Senate healthcare bill was to “reduce the deficit.” Many physicians were operating at a loss even before this series of massive cuts. In 2008, Mayo Clinic posted an $840 million loss in caring for Medicare patients. No businesses can survive when patient care expenses exceed revenue. The second is more ominous— Washington’s increasingly abusive posture toward physicians. President Obama reflected this attitude last summer. On national television, he stated as fact a surgeon is paid between $30,000 and $50,000 for amputating a patient’s foot. In reality, a surgeon is paid between $740 and $1,140 to perform this unfortunate, but often life-saving procedure. This reimbursement must cover a pre-operative evaluation the day of surgery, the surgery, and follow-up for 90 days after surgery—not to mention malpractice insurance, salaries for clinic nurses, and clinic overhead. It is frightening to think our president is so wildly misinformed even as he stands on the cusp of overhauling American health care. But it gets worse. Given massive federal deficits, Washington now faces increasing pressure to cut Medicare spending. One way to do this is to intimidate physicians into under-billing. To do this Washington intends to spend tax payer dollars to ramp up physician audits using Recovery Audit Contractors (RAC audits) to randomly investigate private physician’s Medicare billing. A physician group at my hospital recently experienced an AdvanceMed audit, an earlier version of the RAC. For a year Medicare auditors made their practice a living hell, making them question if it was worth caring for Medicare patients at all. An independent reviewer (who was paid a percentage of the audit) reviewed 86 patient records and “found” the physicians had “fraudulently billed” Medicare for $351,820. After spending a year fighting the allegations, eventually all charges were dropped. The physician group was vindicated but only after spending almost $100,000 defending themselves. The independent reviewers were clearly after money, not justice. For example, one patient the auditor alleged the group had “fraudulently” billed for was a man undergoing a chemical stress test. The allegation was the patient should have undergone a cheaper traditional treadmill stress test. The difficulty with this accusation was this man was a double amputee—he had no legs. This made a traditional treadmill test impossible. The auditors clearly were not trained health care professionals—they were bounty hunters. (It is worth noting the investigators are given legal immunity from a countersuit for conducting a “fraudulent investigation.”) This story is not unique. To reduce Medicare’s budget shortfall physicians are being subjected to these abusive investigations nationwide. If medicine increasingly falls under government control, why should the best and the brightest of our youth give up 15 years of their life to go into medicine? The relationship between the Centers for Medicare & Medicaid Services and the average working physician has become abusive. Mayo is but the first to make the leap to less government control by closing its doors to some patients on Medicare. Washington, slow down and listen; reconsider what you are about to do. Physicians cannot be bullied into bankruptcy. Our system needs reform, but this is not it. If you continue on your present course, sadly, it will be our seniors that pay the price. C. L. Gray, M.D. is president of Physicians for Reform. http://www.foxnews.com/opinion/2010/01/14/c-l-gray-medicare-doctors-deserting-obama/ Bold and Italics are mine. |
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Faux news, it probably never happened.
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Edited by
JustAGuy2112
on
Sun 01/17/10 07:03 PM
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Ah yes.
Of course. The doctor who wrote that is a liar because it just couldn't possibly BE that the government could be utterly inept. http://www.physiciansforreform.org/index.php?id=29 Here ya go. A link to Dr. Gray that has nothing to do with FOX News. And another Non FOX News story written by Doctor Gray. http://www.washingtonexaminer.com/opinion/columns/OpEd-Contributor/Is-Obamacare-the-end-of-Hippocratic-medicine_-8490444-69322157.html |
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One problem is that traditonal medical insurance is also at fault denying clients anything and everything they can get away with. The insurance companies make billions in part by denying people needed medical care. The HMO's and other insurance is publicly traded on the stock market.
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Edited by
Quietman_2009
on
Sun 01/17/10 07:11 PM
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same story
different spin just beacause something is reported by FOX doesnt mean it didn't happen. if they published a blatantly untrue story their competitors would be all over it. they might try to spin the story but they can't actually publish untruths without CNN and CBS and NBC and ABC trumpeting it to the world Mayo Clinic Faulted for Limiting Medicare Patients Critics Say Move Shows That Facility Is Not a Model for Health-Care Reform By Alec MacGillis Washington Post Staff Writer Tuesday, October 13, 2009 The renowned Mayo Clinic is no longer accepting some Medicare and Medicaid patients, raising new questions about whether it is too selective to serve as a model for health-care reform. The White House has repeatedly held up for praise Mayo and other medical centers, many of which are in the Upper Midwest, that perform well in Dartmouth College rankings showing wide disparities in how much hospitals spend on Medicare patients. The model centers have capitalized on their status to insert into health-care legislation provisions that would result in higher Medicare payments for hospitals that do well on the Dartmouth rankings while punishing those elsewhere -- mostly, big cities and the South -- that spend the most per Medicare patient. ad_icon But some skeptics -- health-care analysts as well as politicians and medical officials in states that would be hurt by Mayo's proposals -- argue that low Medicare spending by Mayo and others is driven by the lack of diversity and poverty in their patient population. They say Mayo's low-cost image is belied by the high rates it charges insurers and private payers. Mayo announced late last week that its flagship facility in Rochester, Minn., will no longer accept Medicaid patients from Nebraska and Montana. The clinic draws patients from across the Midwest and West, but it will now accept Medicaid recipients only from Minnesota and the four states that border it. As it is, 5 percent of Mayo's patients in Rochester are on Medicaid, well below the average for other big teaching hospitals, and below the 29 percent rate at the other hospital in town. Mayo officials said Monday it would look for other hospitals to take care of the 50 patients from Montana and Nebraska who have come to the hospital at least twice in the past two years. If there are none, the patients might qualify for charity care at Mayo. Separately, the Mayo branch in Arizona -- the third leg of the Mayo stool, with the Rochester clinic and one in Florida -- put out word a few days ago that under a two-year pilot program, it would no longer accept Medicare for patients seeking primary care at its Glendale facility. That facility, with 3,000 regular Medicare patients, will continue to see them for advanced care -- Mayo's specialty -- but those seeking primary care will need to pay an annual $250 fee, plus fees of $175 to $400 per visit. Mayo officials said Monday that the two moves were "business decisions" that had grown out of longstanding concerns about what it sees as underpayment by Medicare and Medicaid. The officials said they were not meant to influence the national reform debate, in which Mayo has also been advocating against the creation of a government-run insurance option. But they said the moves were indicative of the need for the Medicare payment reforms it has been pushing in Washington. "These decisions aren't based on timing with what's going on with the legislation," said Mayo spokeswoman Shelly Plutowski. "It simply is the reality of the health-care business, and how are we going to be able to continue our mission when these payments are so far below what it costs to provide the care." Skeptics see the moves differently. As it is, they say, Mayo has been drawing a rarefied clientele by charging a premium to Medicare patients coming to Rochester from outside Minnesota. This month's moves, they say, will result in a yet more affluent clientele, and given that Medicare costs correlate with poverty, Mayo's spending data will look only better compared with others. "If your institutions are located in the Bronx or South Central L.A. or other parts of the country with dense poverty, it's hard to compare those patients . . . with places like Mayo," said Atul Grover of the Association of American Medical Colleges. "It's not like they can just stop seeing Medicaid patients, because they live right in their area, and are not coming from hundreds of miles away. They're located right in areas with dense poverty." Mayo spokeswoman Jane Jacobs rejected this, saying that poverty rates can explain only a fraction of the Medicare spending disparities. "To use your patient demographics as an excuse for not getting better is outrageous," she said. The skeptics also question Mayo's argument that it needs to cut back on Medicare and Medicaid patients because those payments are so far below its costs. While Mayo is adept at limiting unnecessary procedures, they note, the costs of the procedures it does provide are high. By extracting such high rates from insurers and private payers, it can pay for top talent and facilities, thus raising its budget and its per-procedure costs. By contrast, a recent report by the commission that advises Congress on Medicare found that hospitals relying most on Medicare and Medicaid, without a big private-payer base, report per-procedure costs in line with Medicare rates -- suggesting that those hospitals can make do with Medicare payment levels. http://www.washingtonpost.com/wp-dyn/content/article/2009/10/12/AR2009101202803.html |
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One problem is that traditonal medical insurance is also at fault denying clients anything and everything they can get away with. The insurance companies make billions in part by denying people needed medical care. The HMO's and other insurance is publicly traded on the stock market. I 100% agree. But.... " Reform " indicates a change for the better. Completely destroying those insurance companies, and therefore losing even more jobs in a country that can ill afford to have more unemployed people, is not " reform ". The government can, and indeed SHOULD pass something that makes the insurance companies cover more people and make it more affordable. But that isn't what they are doing. |
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same story different spin just beacause saomething is reported by FOX doesnt mean it didn't happen. if they published a blatantly untrue story their competitors would be all over it. they might try to spin the story but they can't actually publish untruths without CNN and CBS and NBC and ABC trumpeting it to the world http://www.washingtonpost.com/wp-dyn/content/article/2009/10/12/AR2009101202803.html By the same turn....just because it is reported by FOX News doesn't mean it DIDN'T happen. It's all about the spin. The Left will believe things that are spun the way they like...the Right will do exactly the same. |
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One problem is that traditonal medical insurance is also at fault denying clients anything and everything they can get away with. The insurance companies make billions in part by denying people needed medical care. The HMO's and other insurance is publicly traded on the stock market. I 100% agree. But.... " Reform " indicates a change for the better. Completely destroying those insurance companies, and therefore losing even more jobs in a country that can ill afford to have more unemployed people, is not " reform ". The government can, and indeed SHOULD pass something that makes the insurance companies cover more people and make it more affordable. But that isn't what they are doing. It is all about money and power. |
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It sure isn't about healthcare. Ins.Co.'s exist to make money, profits for shareholders, thats it. The Co.s must take in more in premiums than they spend in payments to healthcare providers. One of my children's bills was $420. for lab work, of which the Ins. paid $42 dollars.
What was the true cost of that lab work? They had to bill $420 in order to get paid $42? And what about the person who had no ins. did they have to pay the full price, or did the lab eat that one? (Write it off and apply for Gov. reimbursement for providing 'charity care'?) |
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Edited by
cashu
on
Mon 01/18/10 08:10 PM
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Faux news, it probably never happened.
this may be correct I don't know . But I do know that MAYO CLINECT HAS STOPPED TAKING IN NEW PATENTS OFf AND ON FOR A LONG TIME because they have so many people go there .they just can't treat as many people who come there and it had nothing to do with madicare . but when it comes to medicaid not many people well take it except hmo's . |
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