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Medicare Payment: Not the Whole Problem

On July 10, the U.S. Senate approved legislation that will delay cuts in Medicare reimbursements to physicians. Already passed by the House of Representatives and on its way to the White House, the bill delays the scheduled 10.6 percent cut for 18 months and provides a 1.1 percent increase in reimbursements to physicians and bonuses for doctors serving in rural communities.

Despite these short-term changes, physicians remain vigilant about the future of Medicare. Will we be able to continue to care for Medicare patients, let alone take on new ones? Unfortunately, the situation is far more complex than the general public believes. The problems we have in caring for older patients reach far beyond possible restrictions in Medicare payment.

We, as physicians, need to engage in dialogue on how to care for patients with serious chronic conditions. Now projected as the leading cause of disability by 2020, chronic conditions are draining the U.S. healthcare system. Heart disease alone cost some $400 billion in 2006, says The Silver Book, while diabetes has increased 50 percent in the last 10 years, according to the National Diabetes Information Clearinghouse. Diabetes now affects some 20.8 million people, but will double by 2020. At the same time, cancer’s price tag is more than $70 billion a year, says the Agency for Research and Quality.

Physicians need to find ways to not only treat chronic diseases within the elderly, but also prevent them. Ozmosis hopes to facilitate a dialogue that extends the discussion from Medicare payment to innovative ways to prevent and treat the chronic conditions. Among the issues for discussion are:

• How have recent decisions related to Medicare payment affected your ability and willingness to take on new Medicare patients? Do you plan to retain your current Medicare patients?
• Do you plan to participate in programs such as Medicare’s Physician Quality Reporting Initiative (PQRI) to compensate for revenue shortfalls?
• What strategies are you using to care for seniors with multiple chronic conditions?
• Which strategies and tactics have been most effective in working toward the prevention of diseases such as cancer, diabetes and heart disease? 

Together, we as physicians can move toward a healthcare system focused more on the prevention of disease rather than exclusively on its treatment. As this discussion continues on Ozmosis, we will share emerging strategies and proposed solutions offered from the community.