Bonus Days Are Over

I stole the headline from the actual article in MedPage Today but who cares? It’s hysterical! As if anyone though that the government would continue these bonuses for PCPs?  One doc in the piece states his group will lose about $100,000 in 2016. The article goes on to say that “across the country, many physicians eligible for the bonus said they haven’t paid attention to the 10% cut because there are so many cuts mixed in with so many incentive payments, like the physician quality reporting program and the value-based payment modifier. It’s hard to follow what impact each has on revenue streams. It also gets mixed up in their minds with new codes Medicare allows for non-face-to-face, wellness, and transitional care.”  Do they not think that was on purpose? So what’s with the the 10% bonus?  Here is how it is explained:

  • It was embedded in the ACA “to address the maldistribution of primary care across the country, as an inducement or signal to younger doctors that it’s okay to pursue primary care” to care for growing numbers of Medicare beneficiaries and 17 million newly enrolled people insured with Medicaid or exchange products.
  • In effect, it helped doctors pay for expensive electronic health record systems they are expected to have, and overhead expenses like malpractice insurance, he said. It was also to help offset temptation to pursue lucrative specialties like radiology or dermatology, “where they could earn three times what a general internist or family doctor makes,” challenges that aren’t going away.

Congress doesn’t want to continue this because they don’t give a crap about family docs so PCPs will suffer.  But should we care?  No. The AAFP should walk away.  Family doctors should run.  Leave Medicare. Leave Medicaid. You are being duped.  Stop being sheep and whining all the time. Show some respect.  I think the clip summarizes my feelings well.


Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  5 comments for “Bonus Days Are Over

  1. Perry
    January 12, 2016 at 10:40 am

    Now, we are not the rats. The rats are the ones in power creating this maze of non-payments for physicians.

    • Beth
      January 12, 2016 at 1:25 pm

      Since health care costs are not coming down, where is the money going, if not to us? If we follow the money, I suggest we will find out who is designing this system. Professional organizations are being led into a dark tunnel.

      • Par
        January 12, 2016 at 9:02 pm

        Crony corporatism. All the doctors who have supported more government “assistance” in health care – and that’s most of them – enabled a Big Gov’t-Big Insurance collusion against the individual.

        • Pat
          January 12, 2016 at 9:03 pm

          ‘”Pat”. Dammit.

  2. Steve O'
    January 12, 2016 at 8:27 am

    Like mice in a maze, we become so proud of our ability to run through the maze faster and faster. How brilliant we are! The smartest of rats! We forget that the cage is actually designed for us, each turn made hard or easy by design, for an ultimate goal that is not our own. Run the maze and get a peanut! Run the maze and get a shock! Do we believe in a Skinnerian view of the world, down deep? Are we all better-fed rats, or starving rats – is that all there is?

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