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H.R. 2844, The Medicare Payment Improvement Act of 2009 (3 comments ↓)
H.R. 2844 would amend title XVIII of the Social Security Act to create a value indexing mechanism for the physician work component of the Medicare physician fee schedule.
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AlexB
June 23, 2009, 5:09pm (report abuse)This is UNFAIR, since every community has a diverse and heterogeneous quality of doctors and there might be groups of doctors that provide good quality and effective care in a community, whose rates would be affected if there is another group of doctors that provide bad quality of care and throw away the numbers for the entire community.
AlexB2
June 23, 2009, 5:15pm (report abuse)This bill may make doctors migrate from areas where the medicare payments are decreased to areas where they are increased. Docs that work in areas with a sicker population, where medicare expenses are higher will not want to be paid less and may move to areas where the demographics (healthier patients) facilitate higher pay rates due to lower medicare usage. This is not fair for doctors that are serving areas with sicker population and is not fair to the patients which may face loosing their doctors.
JormaS
August 14, 2009, 7:40am (report abuse)@AlexB2
I see where you're coming from, but don't agree. The idea that doctor's would migrate to areas with "...higher pay rates due to lower medicare usage." would only make sense if this bill was proposing a change to all insurance payment rates. Since HR2844 would only impact medicare rates, an area with lower medicare usage wouldn't make doctors any more money, despite higher rates.
As for "Docs that work in areas with a sicker population, where medicare expenses are higher..." this just doesn't match the data. Medicare rates are highest not in areas where the poulation is sicker, but in areas where doctors are overutilizing tests, office visits, and procedures because all of the incentives in a fee-for-service system make that seem like a reasonable way for doctors to provide care and get paid for it.
This bill is would reward areas and hospitals like Grand Junction CO or the Mayo Clinic, that provide incentives for quality of care rather than quantity of services.