Tag Archives: medicare

Do the math, a Dr. Shortage is coming

Why the Doctor Can’t See You: Newsroom: The Independent Institute.

The introductory portion of the article documents how preventive care alone has the ability to create full employment for doctors. In other words, demand exceeds supply…

When demand exceeds supply, doctors have a great deal of flexibility about who they see and when they see them. Not surprisingly, they tend to see those patients first who pay the highest fees. A New York Times survey of dermatologists in 2008 for example, found an extensive two-tiered system. For patients in need of services covered by Medicare, the typical wait to see a doctor was two or three weeks, and the appointments were made by answering machine.

However, for Botox and other treatments not covered by Medicare (and for which patients pay the market price out of pocket), appointments to see those same doctors were often available on the same day, and they were made by live receptionists.

As physicians increasingly have to allocate their time, patients in plans that pay below-market prices will likely wait longest. Those patients will be the elderly and the disabled on Medicare, low-income families on Medicaid, and (if the Massachusetts model is followed) people with subsidized insurance acquired in ObamaCare’s newly created health insurance exchanges.

John Goodman concludes…

I predict that in the next several years concierge medicine will grow rapidly, and every senior who can afford one will have a concierge doctor. A lot of non-seniors will as well. We will quickly evolve into a two-tiered health-care system, with those who can afford it getting more care and better care.

In the meantime, the most vulnerable populations will have less access to care than they had before ObamaCare became law.

They call it Obamacare.

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United Healthcare Medicare Advantage cuts doctor network

UnitedHealthcare to cut hundreds of Bay State doctors from its Medicare Advantage network – Nation – The Boston Globe.

National insurance giant UnitedHealthcare plans to cut up to 700 Massachusetts doctors from its physician network for seniors enrolled in its private Medicare plan as a way to control costs, according to company officials.

For elderly patients enrolled in the plan, the cuts mean they will have to find a new doctor or eventually switch to a new health plan that covers their current doctor.

The move, effective Sept. 1, follows similar cuts made by the insurer to its Medicare Advantage provider networks in 11 other states, including in Rhode Island and Connecticut, where the reductions drew outrage from patients, doctors, and lawmakers earlier this year.

Note these cuts are for Medicare participants who use Medicare Advantage plans. If you are using standard Medicare with a Medigap supplement you are unaffected by changes to Medicare Advantage programs. Why are Medicare Advantage benefits being cut? You guessed it, Obamacare.

The changes come amid a gradual reduction of reimbursements to private insurers that offer Medicare Advantage plans as a way to offset costs associated with President Obama’s health reform law.

Medicare Advantage provides coverage for 30 percent of Americans on Medicare through private insurers. Consumers often prefer the program over traditional Medicare because it is a one-stop shop for hospital and doctor coverage, and often includes prescription drugs, eyeglasses, and gym memberships.

For years the federal government has paid the private plans up to 14 percent more than traditional Medicare for identical services, a benefit to the insurance industry that cost taxpayers an extra $1,000 per beneficiary, according to the National Committee to Preserve Social Security & Medicare, a Washington-based advocacy group. The 2010 federal health law was supposed to close the gap, as well as provide new bonus payments to plans with the highest quality ratings.

Perhaps the decision to select either Medicare Advantage or traditional Medicare should involve a little more thought than the lowest premium?

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Medicare: Citing costs, IBM to move retirees off health plan

 
Citing costs, IBM to move retirees off health plan| Fox News

 

In notices signed by Chief Health Director Kyu Rhee, IBM has told retirees in recent weeks that to keep receiving coverage, they will need to pick a plan offered through Extend Health, a large private Medicare exchange run by New York-based Towers Watson & Co.

Medicare is the federally administered system of health insurance for people age 65 and over, and the disabled. Some people buy Medicare Advantage plans, administered by private insurers, and others buy policies to cover gaps in Medicare coverage.

IBM told retirees that its current retiree coverage will end for Medicare-eligible retirees after Dec. 31, 2013, according to documents reviewed by The Wall Street Journal and confirmed by IBM.

IMPORTANT…

Instead of subsidizing retiree health premiums directly, IBM will give retirees an annual contribution via a health retirement account that they can use to buy Medicare Advantage plans and supplemental Medicare policies on the exchange, as well as pay for other medical expenses. Retirees who don’t enroll in a plan through Extend Health won’t receive the subsidy.

Be careful out there. On the other hand, it appears IBM employees are basically getting assistance in paying for Medicare. How do I sign up for that when I retire?

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Obamacare Could Produce $100 Trillion Medicare Shortfall

Obamacare Could Produce $100 Trillion Medicare Shortfall.

Medicare — despite the administration’s rosy forecasts — is headed for a financial crisis, thanks largely to Obamacare, say healthcare experts John Goodman and Laurence Kotlikoff.

The problem?

As for Obamacare, “to pay for the expansion of health insurance for the young, the new health law calls for steep cuts in the growth of healthcare spending on the elderly,” Goodman and Kotlikoff write.

The say “draconian” cuts in payments to providers will have to be made.

Nothing to see here, move along…

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Obamacare’s Negative Impact on Medicare

Obamacare’s Negative Impact on Medicare Will Hurt Seniors.

Ignore the political rhetoric of keeping Medicare “as we know it.” Obamacare has already made significant changes to Medicare, namely through provider reimbursement reductions and the creation of an unelected board of bureaucrats, the Independent Payment Advisory Board (IPAB).

Here’s one of the three examples given…

Huge payment reductions that reduce access to care. According to the Congressional Budget Office (CBO), Obamacare will reduce Medicare reimbursements by $716 billion over 10 years. These cuts will hit Part A providers such as hospitals, nursing homes, skilled nursing facilities, and hospices, along with Medicare Advantage plans. The trustees predict that if Congress allows these cuts to go into effect, 15 percent of Medicare providers would go in the red by 2019, 25 percent by 2030, and 40 percent by 2050.

That’s not a pretty picture. Skilled Nursing facilities are not a place of great service at the present time.

Oh boy, as The Who said in My Generation:

I hope I die before I get old

Well, that’t not my mindset…. yet.

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Unravel Obamacare and You Get a Train Wreck

Unravel Obamacare and You Get a Train Wreck.

Back to the Obama press conference yesterday…

“For the 85 to 90 percent of Americans who already have health insurance,” Obama helpfully informed his audience, “they’re already experiencing most of the benefits of the Affordable Care Act — even if they don’t know it.” Insisting that the implementation has already been accomplished for the already-insured, Obama claimed, “Now they don’t have to worry about anything else.”

Nonsense, scoffed Washington Post fact checker Glenn Kessler. “There are a variety of studies and reports that suggest that, beyond those groups, some 10 million people face the prospect of losing their current health care,” Kessler said in rebuttal to the President’s remarks.

It’s just not a pretty picture. Follow the link to read about:

  • Obamacare applicattion and extensive documentation on tangible assets, alimony and tips for your job
  • Employees being relagated to part time status
  • Reductions in Medicare reimbursements leading to fewer providers

Chaos is coming. Obamacare unleashes a trainwreck. What’s not to like?

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Just How Ignorant Is President Obama About Realities Of ObamaCare?

Just How Ignorant Is President Obama About Realities Of ObamaCare? – Investors.com.

At his press conference this week, President Obama tried to reassure Americans about ObamaCare. Instead, he displayed either an incredible lack of understanding about his own law, or something far worse.

You can view the link for his examples of Obama’s presentation of how well it’s working. The problem is the train wreck coming down the pike as detailed by IBD:

  • Really? The Congressional Budget Office expects 7 million workers — and possibly as many as 20 million — will lose their employer coverage because of ObamaCare. That’s plenty to worry about.
  • The Centers for Medicare and Medicaid Services said millions of seniors will get dumped from their private Medicare Advantage plans by 2017 thanks to sharp payment cuts required by the law.
  • That’s only true if you ignore the fact that ObamaCare’s high-risk pools have been a disaster, attracting a third as many people as predicted while costing far more than the administration budgeted.
  • The overly complicated small-business tax credit has also been a bust, with only about 5% of eligible firms taking advantage of it. And so on.

Read the whole thing as they say.

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Now Medicare is thinking of shutting it off.

Health Quality Partners: If this was a pill, you’d do anything to get it

They are all about bringing down Medicare costs for chronic conditions, which is where most of the money goes…

Kenneth Thorpe, chairman of the health policy and management school at Emory University, estimates that 95 percent of spending in Medicare goes to patients with one or more chronic conditions — with enrollees suffering five or more chronic conditions accounting for 78 percent of its spending. “This is the Willie Sutton rule,” he says. “If 80 percent of the spending is going to patients with five or more conditions, that’s where our health-care system needs to go.”

Health Quality Partners is all about going there. The program enrolls Medicare patients with at least one chronic illness and one hospitalization in the past year. It then sends a trained nurse to see them every week, or every month, whether they’re healthy or sick. It sounds simple and, in a way, it is. But simple things can be revolutionary.

Mathematica is involved in validating the resutls…

Health Quality Partners’ results have been extraordinary. According to an independent analysis by the consulting firm Mathematica, HQP has reduced hospitalizations by 33 percent and cut Medicare costs by 22 percent. (emphasis added)

Others in the profession have taken notice. “It’s like they’ve discovered the fountain of youth in Doylestown, Pa.,” marvels Jeffrey Brenner, founder of the Camden Coalition of Healthcare Providers.

So what’s not to like? Someone should ask the Center for Medicaid & Medicare Services (CMS).

Medicare’s official explanation is carefully bureaucratic. “The authority that CMS had to conduct this specific demonstration, which predated the health care law, did not allow us to make the program permanent and limited our ability to expand it further,” says Emma Sandoe, a spokeswoman for the Centers on Medicare and Medicaid Services. “As we design new models and demonstrations, we are integrating lessons from this experience into those designs.”

Every expert I spoke to — as well as a plain reading of the law — disagrees. If they wanted to make HQP permanent, or scale it up in a big way, Medicare has the power to do so. Then there’s this: “Thanks to the health care law, we can now test new, innovative models for delivering health care and expanding models that show promise,” Sandoe continues. “With this new authority, we can take best practices to scale and provide more incentives to deliver high-quality health care at lower costs.” (emphasis added)

Government is NOT going to make health care better and more innovative. No way, no how. The sun will turn into a red giant and engulf the earth before that happens.

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Followup on Opthamologist walk out of Obamacare talk

Kris Held MD tweets:  Drs are literally walking out of this talk on implementing, complying with Obamacare. We are men and women of the mind, not mindless drones.

Stuart Varney of Fox Business News follows up with Dr. Held:

 

Kris Held MD tweets: Drs are literally walking out of this talk on implementing, complying with Obamacare. We are men and women of the mind, not mindless drones.

Stuart Varney of Fox Business News follows up:

 


Money is taken away from the seniors, taken away from procedures they need like treatment for their macular degeneration, their cataract surgery and funneled to other parts parts of the law. And so I believe that it’s going to result in the rationing of care, the denial of care based on a patient’s age, based on their disabilities.

 

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Obamacare To Slash Hundreds Of Billions From Medicare Advantage Over Next 10 Years

Obamacare To Slash Hundreds Of Billions From Medicare Advantage Over Next 10 Years – Forbes.

The CMS flip-flop is good news for seniors and taxpayers alike. But Medicare Advantage is not out of the woods yet. Obamacare is set to slash hundreds of billions from the program over the next 10 years.

That’s a mistake. Medicare Advantage delivers better care at lower cost than does conventional Medicare. The program should be expanded — not cut, as the president and his allies advocate. (emphasis added – Ed)

Some 14 million seniors — more than a quarter of all beneficiaries — have enrolled in Medicare Advantage.

Famous last words: “If you like your plan you can keep it….”

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