Points of Interest 04/28/2014

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.

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