Beruflich Dokumente
Kultur Dokumente
Medicare
AAPS
Thrive Not Just Survive XXIV Workshop
Dallas, Texas
05-20-2016
Lawrence R. Huntoon, M.D., Ph.D.
Association of American Physicians and Surgeons
Reasons
for
Opting Out of
Medicare
Physician Burnout
The prevalence of burnout is higher in
physicians than in other professions and is
especially high in neurologists.
Physician
burnout
encompasses
3
domains:
(1)
emotional exhaustion: the loss of interest and
enthusiasm for practice; (2) depersonalization:
a poor attitude with cynicism and treating
patients
as
objects;
and
(3)
career
dissatisfaction: a diminished sense of personal
accomplishment and low self-value. Burnout
results in reduced work hours, relocation,
depression,
and
suicide.
Burned-out
physicians harm patients because they
lack empathy and make errors.
Physician Burnout: A Neurologic Crisis
Increasing Bureaucracy is
a Major Contributor
To
Physician Burnout
Medicare
Obstructs, Impedes, and
Interferes
with
Nearly Every Aspect
Of
The Practice of Medicine
BUT
I really cant do it in my areaI am
surrounded by competitors all of whom
participate in Medicareand all of my
Medicare patients will leave and go to
my competitors if I Opt Out, and I will be
out of business.
Fear
of what MAY happen if you Opt Out of
Medicare or if you stop signing abusive
one-sided insurance contracts is the
FENCE
that confines you in the pen
2.
NY Times
http://www.nytimes.com/2015/06/02/upshot/to-be-sued-less-doctors-should-talk-topatients-more.html?_r=0&abt=0002&abg=0
Risk
Of
Prosecution, Prison
And
Ruinous Fines
Effects of ObamaCare
Increased federal sentencing guidelines by 2050% for crimes over 1 million in losses
Increased license checks and site visits for
physicians deemed to be high risk for fraud and
abuse
CMS implemented advanced predictive
modeling technology to detect fraud
Provided an additional $350 million over 10
years to boost anti-fraud efforts
Spending More
Face- to-Face Time
with Patients
Makes for Much
Happier Patients
SGR
Defeated
(A Cause for Celebration?)
ObamaCare/MACRA Agenda
Like ObamaCare, MACRA is designed to
eliminate solo physician and small group
practices and force physicians into
hospital employment and/or large ACOs.
The goal is to eliminate fee-for-service
medicine and replace it with ACOs
subject to government control.
Centralized government control of
medicine is the ultimate objective.
MACRA
What will Happen to Physicians
Who Remain in Medicare?
Price Controls IPAB
Alternative Payment Models
Capitation on Steroids
(ObamaCare ACOs money paid to
Alternative Payment Models Not to
Individual Physicians)
Non-Financial Considerations:
The freedom and pleasure of practicing medicine
again,
instead of practicing bureaucracy (Kick the Gorilla
out of
your Exam Room) happiness replaces physician
burnout
2.
Positive patient experience and protecting patient
privacy
3.
No fear of ruinous fines or prison time for inadvertent
coding
errors or running afoul of some obtuse Medicare law,
rule,
regulation (Medicare bounty hunters RACs, and
ZPICs no
longer a worry)
4.
Simplification Opt Out physicians need not use any
1.
2.
3.
AAPS
1-800-635-1196