ACO's --> end of solo? --> Re: Anyone Following This?

[Guest guest]

My husband, , sent me the following excerpts from Wall Street Journal. My comments are highlighted in green:

Primary-care doctors who refer patients to specialists will face financial penalties under the plan. ALTHOUGH ALL OF US THINK THAT THIS PROVISION WILL NOT PENALIZE US, SOMEONE, WHO MAY BE AN EXCELLENT PHYSICIAN, MAY GET PENALIZED. Doctors will see 5% of their Medicare pay cut when their "aggregated" use of resources is "at or above the 90th percentile of national utilization," according to the chairman's mark of Section 3003 of the bill. Doctors will feel financial pressure to limit referrals to costly specialists like surgeons, since these penalties will put the referring physician on the hook for the cost of the referral and perhaps any resulting procedures.

Next, the plan creates financial incentives for doctors to consolidate their practices. The idea here is that Medicare can more easily apply its regulations to institutions that manage large groups of doctors than it can to individual physicians. So the Obama plan imposes new costs on doctors who remain solo, mostly by increasing their overhead requirements—such as requiring three years of medical records every time a doctor orders routine medical equipment like wheelchairs. THIS MAY BE ENOUGH OF A BURDERN TO FORCE MANY OF US, IN SOLO PRACTICES, OUT UNLESS WE NO LONGER ACCEPT MEDICARE. THE ELDERLY WILL LOSE ONCE AGAIN. IF THIS PROVISION BECOMES A REALITY, IT MIGHT MAKE ME CLOSE MY SOLO PRACTICE. I, LIKE THE REST OF US, LOVE MY PATIENTS, THINK I PROVIDE GOOD CARE TO THEM AND WOULD HATE TO SEE THEM LOSE OUT ON CARING PRIMARY CARE.

The plan also offers doctors financial carrots if they give up their small practices and consolidate into larger medical groups, or become salaried employees of large institutions such as hospitals or "staff model" medical plans like Kaiser Permanente. One provision, laid out in Section 3022, allows doctors to share with the government any savings to the government they achieve by delivering less care—but only if physicians are part of groups caring for more than 5,000 Medicare patients and "have in place a leadership and management structure, including with regard to clinical and administrative systems." THERE ARE MANY REASONS WHY WE HAVE SMALL PRACTICES AND PATIENTS CHOOSE US FOR THEIR MEDICAL CARE BUT WE NEED ACTUAL DATA TO PROVE OUR POINTS. AND THIS DATA HAS TO BECOME AVAILABLE SOON!

REMEMBER THIS IS FROM WALL STREET JOURNAL. I HOPE THEIR ANLYSIS OF THE PLAN IS TRYING TO SCARE US AND IS NOT THE REALITY.

ALLA

Alla Kirsch, M.D.Travel Clinics of America6559 Mills Road, Suite 107, Mayfield Village, OH 44143 | fax | www.travelclinicsofamerica.com

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