Paying Doctors for Patient Performance

 Not long ago, a fellow doctor told me that his local health care insurers, in an effort to improve care and rein in costs, had been evaluating physicians and paying them according to their “quality ranking.” With “pay for performance” reimbursement, doctors who had, for example, managed more timely follow-up and achieved better test results with their diabetic or hypertensive patients would rank more highly and earn more in financial bonuses than physicians whose patients failed to meet the insurers’ guidelines.

• More Doctor and Patient Columns

Despite his own solid “ranking,” my colleague found himself growing more and more disenchanted with these types of reimbursement programs. “It sounds like a great idea,” he said, “but it assumes that what I do or say always has a direct effect on my patients’ health.” He described a long-term patient he had seen earlier in the week; she had poorly controlled diabetes yet failed to come into his office regularly in spite of his numerous requests.

Leer completo...

Health Insurance Blame Game – Stuck Between Insurance Company and Doctor’s Office

Do you ever feel like navigating the health insurance claim process is like walking through a maze blindfolded?  Our most recent experience leaves me wondering how many people get stuck paying hundreds of dollars for claims that should have been covered.
During a recent visit to the pediatrician the receptionist informed my wife we had a balance of over $300 outstanding. Luckily she only paid the co-pay and got the phone number of the billing department so I could call and investigate.
Doctor’s Office Perspective

Leer completo...

Doctor healthy Tips (Don't Let Your Anger Kill yourself)

Your Body: User’s Manual (Chapter 2)

Many believe that expressing our dissatisfaction and anger verbally or acting it out helps us deal with the negative feeling and stops it from harming us. However, recent scientific studies show that individuals who get cross are more prone to sufferstrokes, and sudden death. They are even more at risk than individuals with so-called “Type A Behavior”. Men who get angry are also more prone to aheart condition called “atrial fibrillation” where the atrium of the heart contracts quickly but ineffectively to pump blood around. This precipitates embolism and strokes. In the states, over 2 million people suffer from atrial fibrillation. With regard to sudden death, hot tempered men are at 1.2 times risk that of their calmer counterparts. A word on “Type A Behavior”: this describes those individuals who put their emphasis on ambition, efficiency, speed and competition. When we mention the term, we picture the quick-tempered, argumentative, impulsive, inflexible and loud-talking individuals. They are more prone to develop heartdisease.

Leer completo...