Points of
Interest
April 28, 2014
Why
doctors need to care about price transparency ?
As healthcare costs become a bigger and bigger chuck of our
Gross Domestic Product (GDP), price transparency is a subject that insurance
companies and patients are talking about. The idea of knowing how much
something costs, be it canned black beans in the grocery store or replacing the
leaking faucet in your kitchen, seems obvious but it will be an uphill battle
to enact change within the healthcare system.
Transparency
is here, and it’s hunting season on doctors
The data released by Medicare includes the doctor’s name,
address and specialty. For each physician, there is a list of CPTs performed
for more than 10 patients during CY 2012, and for each CPT there is the number
of unique patients billed for the procedure, the number of times the procedure
was performed (or billed to Medicare), the average charge per CPT and the
average payment for the same. There are over 800,000 names on the list (not just
physicians), so chances are good that unless you are a pediatrician or a
concierge doc, your name is on it. Of course, this is just the preliminary raw
list, but given enough time and innovative efforts, many, many sub-lists will
be evolving. Even before the list was released to the public, several
publications with advanced media access, managed to quickly produce
high-spender lists, so stay tuned to your favorite news outlet for more to
come.
The Medicare spending we should be concerned about
Here are the payment figures that really
caught my eye:
·
$12 billion spent on
outpatient visits in 2012, with average reimbursement of $57 per visit. This is
out of a total Medicare spending of $600 billion for the year.
·
$77 billion overall
paid to doctors and health care providers. (Unclear to me whether this is just
Part B, or also includes payments to doctors during hospitalizations.)
·
$13.5 billion spent on
“commercial entities like clinical laboratories and ambulance services.”
Look at that. Outpatient visits are 2% of
Medicare spending. And at $57/visit, is it any wonder that primary care for
seniors is often woefully inadequate?
We spend more on laboratory services and
ambulances than we do on outpatient visits.
How generations of doctors will handle health
care change
With American health care in the midst of
rapid transformation, both doctors and patients will be forced to adapt to
changes stemming from the Affordable Care Act, also known as “Obamacare.”
Of course, everyone responds to change
differently. But is it possible to predict how doctors will adapt to health
care reform based on the year they were born? The answer may surprise some
patients and even force them to think differently about who provides their
care in the future.
How different are the generations, really?
A lot of data exists on the characteristics
that define and differentiate generations. While none of that data can paint a
totally accurate picture of any one doctor, the research does allow us to cover
the canvass in broad strokes:
Baby boomers (born 1946-1964) .
Millennials (born 1984-present) .
How generations of doctors will handle change
Not all generational generalities are
foolproof: Some baby boomer physicians are as high-tech as the savviest
millennials and plenty of Generation X doctors put in long hours.
