tag:blogger.com,1999:blog-9181810725696409953.post5353265150813757875..comments2024-03-17T04:20:11.083-04:00Comments on The Population Health Blog: If They Build a Medical Home, Will the Docs Come?Jaan Sidorovhttp://www.blogger.com/profile/05072456803925863874noreply@blogger.comBlogger4125tag:blogger.com,1999:blog-9181810725696409953.post-38582337974248712942008-12-12T17:22:00.000-05:002008-12-12T17:22:00.000-05:00What we have is fundamentally a pricing problem in...What we have is fundamentally a pricing problem in primary care. If you look at the Medicare conversion factor in 1998 (the first year of the unified conversion factor) it was 36.6873. @009 will be 36.066. So, in 12 years we are down in absolute terms. When adjusted for inflation in practice costs and spending power of residual, a conservative estimate is that the buying power of this cut in time is about 50%.<BR/><BR/>The PCMH promises substantial monthly payments in the Medicare model. At a range of $27 to $100 monthly for the management fees, this has the chance to revolutionize the financial productivity of primary care (see http://www.cms.hhs.gov/DemoProjectsEvalRpts/downloads/MedHome_FactSheet.pdf)<BR/><BR/>With a typical Medicare panel of 300 patients for a Family Practicioner (more for Internists), the range of annual revenue INCREASE is $133,000 at $37pppm or $360,000 at $100pppm. At the higher end of the spectrum you are looking at nearly double the revenue.<BR/><BR/>This amount of money on the table can dramatically alter the attractiveness of primary care.rtsmdhttps://www.blogger.com/profile/09577070823614685914noreply@blogger.comtag:blogger.com,1999:blog-9181810725696409953.post-74656794172914385452008-11-20T21:33:00.000-05:002008-11-20T21:33:00.000-05:00If Obama mentions it he may be more Eisenhower tha...If Obama mentions it he may be more Eisenhower than FDR (interstate). I am more Jeffersonian, but fellow Jeffersonian Milton Freedman agrees (Captialism and Freedom) that government should build infrastructure that private capitalists can or will not. They did a good job with the creation of the internet through DARPA. Now that the current EMRs use this highway, they should regulate the traffic much the way they do with trucking and let the data fly!tangsoodochttps://www.blogger.com/profile/13296014202099544391noreply@blogger.comtag:blogger.com,1999:blog-9181810725696409953.post-52358484384328710712008-11-20T21:02:00.000-05:002008-11-20T21:02:00.000-05:00I think I'm a taekwondoc, which makes me even more...I think I'm a taekwondoc, which makes me even more inclined to agree with your comments I think the inertia characterizing e-record adoption is one additional reason why the medical home (which includes an EHR) is being pushed. <BR/><BR/>Docs haven't rushed to the EHR for many reasons, which may portend their reaction to the medical home, even if President Obama mentions THAT in a future State of the Union Address.<BR/><BR/>Maybe the fix is to jettison the market and get the government to launch the satellites....<BR/><BR/>Guest posts welcome. The space is rent free.<BR/><BR/>Chariot - KunyeJaan Sidorovhttps://www.blogger.com/profile/05072456803925863874noreply@blogger.comtag:blogger.com,1999:blog-9181810725696409953.post-8599730479217858002008-11-20T19:58:00.000-05:002008-11-20T19:58:00.000-05:00Since you asked.....I am rural family practitioner...Since you asked.....<BR/><BR/>I am rural family practitioner located 25 miles from the nearest hospital. I am also a part time medical director for a medium size insurance company. My clinical practice recieves data from at least 5 disparate health systems, various and sundry labs, consultants, homehealth agencies and ancillary providers.<BR/><BR/>I keep wondering if all of the contemplation over p4p, disease management and medical home is like designing a better cruise control and GPS before the advent of satellites and an interstate highway system.<BR/><BR/>For someone like myself, until there is a unified scaleable searchable national medical record with a central depository that can be accessed by all players (practice,hospital,ancillary,payer,patient,pbm,etc), there can be no meaningful data mining to quantitate and enhance the betterment of health outcomes in this country. <BR/><BR/>I would comment further, but I am out of space.tangsoodochttps://www.blogger.com/profile/13296014202099544391noreply@blogger.com