Paying doctors more may be good for patients

[flashl]

Program claims avoiding costly illnesses is worth it

By MILT FREUDENHEIM
THE NEW YORK TIMES

Cutting health costs by paying doctors more?

That is the premise of experiments under way by federal and state government agencies and many insurers around the country.

The idea is that by paying family physicians, internists and pediatricians to devote more time and attention to their patients, insurers and patients can save thousands of dollars downstream on unnecessary tests, visits to expensive specialists and avoidable trips to the hospital.

Nationally, Medicare and commercial insurers pay an average of only about $60 a visit to the office of a primary-care doctor and rarely if ever pay for telephone or e-mail consultations. Many health policy experts say the payments are not enough to let the doctors spend more than a few minutes with each patient.

..

"We are trying to do more e-mail care and telephone care, which we haven't been paid for in the past," Baron said.

Insurers are conducting similar pilot projects in at least half a dozen states, in experiments involving thousands of doctors and nearly 2 million patients. Many more are in the planning stages, at the urging of health policy experts and employers that provide medical benefits.

Seattle PI (NY Times)

[DaveJ]

1. $60 plus a $20 copay

I'm sure doctors see most problems on a regular basis, so if someone has a simple ailment that requires a prescription, it only take a few minutes.

After the cost of overhead, I realize that isn't enough to make every family doctor ubber rich, but $80 for 10-15 minutes seems fair to me.

I agree that they should get more if they provide more personalized attention, AND even if they have more experience or are better rated than others.

But I'm not going to support just unquestioningly making anyone rich without some solid justification.

[flashl]

2. Isn't the 'extra' personalized attention here is the email and telephone call? nt

[DaveJ]

5. Sure, our last doctor even had a website...

His website allowed patients to check his schedule and make thir own apppointments online.

It was great, but then our insurance provider changed. :-(

Anything like that which provides higher quality service should be compensated.

[chicagomd]

4. It is not paying more, per se,

but paying for what is being done.

If I call, e-mail, or answer a page at 2am those services are not currently billable to most insurance companies unless you can fold them into a previous charge. If not, physicians then have have to decide if they want to go after the patient for the balance or just not bill those contacts.

Personally, I do not care about not being able to bill for those things, despite the number of calls I field after hours. The issue that gets me is EVERY encounter (even when your cousin stops you in the grocery store to look at a mole,) with a patient exposes physicians to legal liability for that interaction. This sets up a pretty nasty double standard: I can be sued for advise given at that 2am phone call, but I cannot bill for the services rendered. All risk, no reward.

[DaveJ]

6. Yep, that's another thing that should be fixed.

If I could control the system I'd make it impossible to win a lawsuit in situations like that. Litigiousness really takes its toll on society.

[DCKit]

3. Back in "Teh Olden Daze"....

We used to call that "preventative medicine."

WTF is wrong with people?