Monday, February 18, 2013

Your (Examination) Table is Ready...

We've been writing about the coming wave of "concierge" medicine for over six years, so this is nothing new to our readers:

"New data from a national survey of nearly 14,000 physicians ... found that 9.6 percent of “practice owners” were planning to convert to concierge practices in the next one to three years."

That's nearly 1 in 10 practitioners, which is pretty significant. The usual suspects are cited: low Medicare and private reimbursement rates, which are only getting worse under the ObamaTax. And the so-called "Doc Fix" continues to hang as an albatross around the future's neck.

What's even more frightening, though, is that the phenomenon seems to be specialty-independent; that is, it's not just primary care, but surgeons and oncologists and, well, the list goes on. Which makes sense: health care is (pretty much) health care, and someone has to pay for it.

Which brings us to the uptick in concierge-style medicine. Some 20 percent of docs already restrict "the number of Medicare patients in their practice and one in three primary care doctors – the providers on the front lines of keeping the cost of seniors’ care low – are restricting Medicare patients." So if you can't get into your primary care doc, good luck getting a referral to that cardio guy you need to see.

Concierge-style medicine seeks to get around that problem by having patients contract directly with the provider. Of course, this will work better for some practice areas than others, primary care being the most obvious. How - or even if - this would work with, say, surgeons or radiologists seems unclear at this point. On the other hand, it was essentially the premise (and "promise") of HMO's. On the other hand, we've seen how those have worked out over the past decades.

The biggest problem right now is the threat that HHS Secretary Shecantbeserious will pull another mandate out of pocket and render the whole point moot.
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