Robert Pear at the New York Times offers an excellent summary of findings by the General Accountability Office that the procedure
used by the Medicare agency (CMS) to determine the relative weightings for $70
billion physician payments has major flaws.
That CMS weighting is also used by most private insurance companies as
the basis for physician payments. This
is a topic that has received coverage over the years, but little has changed.
(A pause here to ask and refer back to a previous post: When was the last time you heard one of the
Triple Aim advocates—inside or outside of CMS--take on this issue, which has a
direct result in how much primary care doctors and other cognitive specialists
get paid?)
But, there is an important reminder in this story. Pear notes (with my emphasis added):
“Under federal law, Medicare fees are supposed to reflect the
time required to perform a service and the intensity of the work.”
Uh oh. Let’s consider
how the pervasive use of robotic surgery will factor into this calculation. For example, in the past, most
prostatectomies would have been done as open procedures or using a manual
laparoscopic approach.
Now, due to a highly successful marketing campaign by
Intuitive Surgical and by doctors and
hospitals that have showcased their robotic surgery program, the vast majority
of these cases are performed robotically.
This has increased the required time in the operating rooms.
The same applies to other procedures in which Intuitive has
made and will make inroads—gall bladder removal, hysterectomies, hernia
repairs, and so on.
Is this a back-door way for surgeons to receive more money
for the same procedures?
2 comments:
From G+:
It's more like no door at all.
I'd have to agree with Gary Levin. The constant asking for money is because the govt. is not stopping the business juggernaut.
Post a Comment