The motivation for pursuing quality should come from the accountable care organizations establishing a vehicle for groups of providers to voluntarily meet quality thresholds and share in cost savings achieved for the Medicare program. Bonus payments for primary care physicians and general surgeons of up to 5% of fee schedule amounts would be provided to physicians who furnish at least 60% of their services in specified ambulatory settings or practice in rural scarcity areas.
In summary, the proposed Medicare changes increase high end imaging equipment utilization rate modestly to 60% from the current 50% starting in 2010. Certainly, revenue and profits will be reduced, especially for sites that treat a high number of Medicare patients. If there is a silver lining, it might come in the form of bonuses paid for quality clinical decisions, but who will judge quality? Will lower reimbursement be offset by greater utilization and patient volume?
Finally, consider the three-headed proposals, and the implications resulting from H.R.3200 America's Affordable Health Choices Act of 2009, as introduced in the House, colliding with the Senate Finance Committee America's Healthy Future Act of 2009, or the Senate HELP Committee Affordable Health Choices Act proposals. What amalgamate, if any, will arrive in the President's lap to sign? Do you want him to sign an amalgamate of those Acts?
Paul Keough, PhD, is the President at Turnkeough Corporation (www.turnkeough.com). You can reach Paul at paul@turnkeough.com.Back to HCB News
