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Thu Mar 26, 2020, 07:32 PM

Why The Pandemic Is Putting Primary Care Docs In A Major Financial Pinch

By Tierney Sneed
|
March 26, 2020 1:28 p.m.

We’re only at just the beginning of the COVID-19 outbreak, and already primary care providers are warning that their medical practices might not survive the pandemic.


The issue is not just treating the coronavirus itself, though primary care providers are facing the same challenges plaguing hospitals, with a lack of testing, equipment shortfalls and a need to keep their staff virus-free.

But the overall shift away from in-person interactions has overnight turned the landscape for health care on its head, scrambling the financial model for medical practices that Americans rely on for routine and minor medical issues.

Those providers are now warning that, without a major influx in cash or a change to how business is done, they might need to close their practices in weeks, not even months.

https://talkingpointsmemo.com/news/primary-care-doctors-coronavirus-financial-challenges

We are so screwed...........................

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Response to turbinetree (Original post)


Response to flibbitygiblets (Reply #1)

Thu Mar 26, 2020, 08:00 PM

2. Our system is antiquated and inefficient.

CMS policy is the proof.

-Laelth

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Response to flibbitygiblets (Reply #1)

Thu Mar 26, 2020, 08:01 PM

3. My doctor was sent home by his practice

They have 450 doctors and told all pcp’s to go home. They are using video where possible.

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Response to PuppyBismark (Reply #3)

Thu Mar 26, 2020, 09:03 PM

9. I called my doctor today to cancel an appointment scheduled a month ago because...

of sheltering in place. His receptionist said there was no reason to cancel as the doctor will do the appointment by phone.

I agreed but now that I think about it, a telephone interview can't take my blood pressure, temperature, heart rate, etc. And I'll probably be billed at the usually rate.

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Response to flibbitygiblets (Reply #1)

Thu Mar 26, 2020, 08:23 PM

6. That has just changed and CMS is encouraging telemedicine. Medicare Advantage

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Response to Hoyt (Reply #6)


Response to flibbitygiblets (Reply #7)

Thu Mar 26, 2020, 08:52 PM

8. Sounds like the Medicare Advantage plan is trying to maximize their Risk Adjustment, in

a damn pandemic of all things.

Have your CEO call me, I have a few choice words for him.

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Response to Hoyt (Reply #8)


Response to flibbitygiblets (Reply #10)

Thu Mar 26, 2020, 09:20 PM

11. To require patients in pandemic to go see a provider face-to-face to increase Plan's Risk Adjustment

is down right criminal.

The Plan gets paid for a telemedicine encounter just like an office or any other encounter through their monthly amount from CMS. The Plan is just looking for diagnoses to get a special bonus -- the Risk Adjustment. That's immoral, unethical at best in this case, putting patients and doctors at risk.

I am generally for Medicare Advantage Plans and have taken a lot of heat here for that. But this is wrong.

This is not about free care that the Plan is not getting reimbursed by the government for. This plan is putting patients and providers at risk.

Can you give me the name of the plan?

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Response to Hoyt (Reply #11)

Thu Mar 26, 2020, 09:28 PM

12. No, because you are incorrect in your facts. You seem to want to be outraged, so carry on I guess.

We have a lot of people to care for and you seem hell-bent on taking up our time so we can educate you.

Your statement "The Plan gets paid for a telemedicine encounter just like an office or any other encounter through their monthly amount from CMS."

is factually inaccurate, as I explained.

And BTW, it's not the plan that requires people to come in in person, please read what I wrote. It's CMS that has structured it that way. The plan I work for has actually called off efforts to get people to come in for a face-to-face visits, as soon as the pandemic began. Our telehealth visits have skyrocketed and we're happy about that. We're just not getting reimbursed for the expense of caring for any DIAGNOSIS that's coded during such a telehealth visit. Not just for the visit, for the whole diagnosis! If a person has COPD, HIV, heart disease, diabetes, you name it, if it's coded on a telehealth visit, to CMS it doesn't exist, and isn't reflected in the premium.

Your outrage should be directed at CMS. People just think that all health insurance plans are evil, and it's often true, but not always.

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Response to flibbitygiblets (Reply #12)

Thu Mar 26, 2020, 09:38 PM

13. I do know the facts. And I know the name of the Plan, begins with a _. I'm really disappointed

Last edited Fri Mar 27, 2020, 09:35 AM - Edit history (1)

in that, because I used to recommend them to people in areas where they have plans, saying they were Non-Profit and all that.

I fully understand how Risk Adjustments work, believe me. And I still think what _ is doing is immoral and unethical, at best, even if best for their bottom line.

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Response to Hoyt (Reply #13)

Thu Mar 26, 2020, 09:40 PM

14. I give up. /nt

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Response to Hoyt (Reply #13)

Fri Mar 27, 2020, 03:47 AM

15. Is it no longer against the terms of service to post members' personal private info?

or to attempt to do so?

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Response to turbinetree (Original post)

Thu Mar 26, 2020, 08:02 PM

4. Kick

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Response to turbinetree (Original post)

Thu Mar 26, 2020, 08:06 PM

5. I know a professional in such a situation.

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