The push needed by the healthcare system- Medicare’s doctor pay announcement

Everyone has heard about how medical care will change with the arrival of telemedicine. Instead of having to take time off work to go meet the doctor, all that would be required is to log in. However, we’re yet to actually be able to use it.

This is exactly what a recent announcement made by the Obama Administration was all about. When the Health and Human Services made the announcement that its goal was to speed the changes in the way through which doctors are paid that is by making use of half the funds for those who coordinate patient care by 2018, the idea was actually to speed changes as to how the health care system works for patients. According to Frank Williams, the CEO of Evolent Health, what this suggests is that the government has had a number of years to look at the results of the various organizations who have been trying value based care and the government now believes that these ideas have been working well enough which is why the entire system is to be moved in the same direction.

The private sector follows wherever Medicare goes. Thus hospital executives are likely to be watching closely as to what the next step is going to be. This was stated by the CEO of Aledade, a company which helps doctors form Accountable Care Organizations which are closely connected to compensation and providing quality care. He also said that executives within the health care system are constantly making plans and investments based upon what they believe is likely to happen in the future. Everything that is invested in today depends upon what is going to happen in the upcoming future.

He also said that within the private sector, most health care is fee for service or in other words, the more a doctor treats a patient, the more he will get paid. Now however it will become about how care can be improved at a lower cost or at least deliver the same care at a lower cost. The big question however now is that whether or not the private sector will also follow in the same footsteps?

According to Jay Shiver from the George Mason University, there are likely to be winners and losers and the first phase is going to be very painful for the latter. Organizations which are still small or physician practices which have yet to invest or link with an organization having an IT infrastructure to identify and be better able to manage their patients, will be hit the hardest. Questions have also risen regarding how the idea of value based care can go far and actually lead to the rationing access of technology and care. It is likely that the government would have to keep a close eye on this experiment and make changes along the way in order to avoid any problems. Furthermore, questions have also risen regarding whether or not the right metric is being used by the Department of Health and Human Services.


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