Alternative Payment Models

It turns out that physicians are starting to realize that these new payment plans based on quality and risk are a joke,  It sure took them long enough.  This comes from the MGMA:

The poll, from the Colorado-based Medical Group Management Association (MGMA), garnered nearly 1,200 responses from its members. Seventy-two percent said that the government should not mandate participation in Medicare alternative payment models; 14 percent said they should mandate participation; and 14 percent they were unsure.

“Despite support for APMs, a large majority of physician practices oppose government mandated participation, citing lack of evidence, diversity among medical practices, and the negative impact on practice innovation,” said Anders Gilberg, MGMA senior vice president of government affairs.

Lack of evidence?   Not really.  There are tons of evidence showing that quality metrics DO NOT work!

Here’s a new idea.  How about we use cash.  Let’s make prices transparent so that people can shop around.  And then we will see what happens.

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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] 

  3 comments for “Alternative Payment Models

  1. RSW
    March 5, 2018 at 8:47 am

    “Let’s make prices transparent”

    Of course, with the new so-called value-based payments, absolutely no one – physician, patient, insurer – will have any idea how much a service costs or how much will be paid for it, until a year or two down the line when all the quality measures and other mitigating factors have played out. Shopping around will be impossible.

    What a mess.

  2. Steve O'
    March 3, 2018 at 8:27 pm

    Unless something in medical management affirms the sentence – This may increase the cost of providing care – it is designed to decrease the expenses of medical care. Nothing will be tolerated in the current climate that can possibly assert “This may increase the cost of providing care.” Therefore every innovation will decrease cost.
    There is no intent of “improving metrics.” The people who thought honestly like this were discarded years ago – don’t go appealing to them! It’s the single-minded nowadays.
    Even Stalin had show trials, to accuse the Old Bolsheviks of outrageous crimes. That way, he could have them shot, and the newspapers had an explanation to publish. There is still a flicker of conscience that makes people uneasy as they tear apart the greatest medical system in history. Show trials make everyone feel better about the problem.

  3. Frank J Rubino MD
    March 3, 2018 at 10:30 am

    Doug and friends,
    I am reading a pertinent book on the metric scam – “The Tyranny of Metrics” by Jerry Z. Muller.
    MBA’S of this world are obsessed with quantifying human performance and consequently threatens schools, medical care, business and government. Even the military and police are held hostage to the holy grail of “metrics”. It is a well researched volume on this annoying topic. The author is a professor of history at Catholic University of America in Washington, DC. It has a wealth data that supports what we physicians have been thinking since metrics have been applied to our profession. I would recommend this to all Authentic Medicine subscribers.

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