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.