The Game Of Medicare

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Have you accompanied a Medicare age friend or family member to a physician’s office and find yourself presented with a heap of medical questionnaires? I am terming this the event of being “Medicared.” I admit this is a term I concocted. However if you have been Medicared in the past year, you know of the stack of forms of which I refer.

Routine Doctor Visit “Medicared”

Have You Been 'Medicared'? Playing the game of Medicare increases patient paperwork while offering physican financial incentivesLast summer I accompanied my mother to her internist for an appointment. It was supposed to be a ‘routine’ appointment. Well, routine if you consider she was recovering from a bout of pneumonia. This was her first visit post pneumonia to the internist office.One can imagine when not feeling particularly perky and recovering from pneumonia, the last thing one wants is to be presented with questionnaires and stack of forms which appeared to have nothing to do with her internist visit.

When I looked at the questionnaires, which were basically looked like year reviews of the medical history, my first question to the staff was, “Why?” and “What exactly are these?” My thought was all this information was contained in the file. I received the vague answer of it was required paperwork. I thought, “Really, required since when? This paperwork has never been presented before?”

I asked that the paperwork be delayed, the staff wasn’t happy, but we were in the office due to a current illness which as we know at doctor’s offices, efficiency and immediacy does not always relate to a quick visit.

Second Visit “Medicared”

The same paperwork and staff urgency was presented at the second follow up visit. I asked again as to what exactly all this paperwork was and why is it necessary. Clearly this information was in the files. The staff and internist stated is was procedure. Perhaps, but it certainly had never been procedure prior to 2014.

Physician Quality Reporting System

Further research revealed that indeed what I have termed Medicared is the Physician Quality Reporting System which financially rewards for physicians who complete the paperwork under the Affordable Care Act. Beginning in 2015, penalties will be instituted for those physicians which do not comply with the reporting standards. 

Critics of the program maintain the paperwork or what I term being Medicared, is time consuming and of little benefit to the patient. From a patients’ perspective I agree with that assessment. It has been reported some physician voluntarily forgo the reporting because it is less expensive to incur the penalties then delegate staff to handle the reporting requirements.

The Centers for Medicare and Medicaid Services (CMS) have acknowledged the process for the Physician Quality Reporting System are scheduled to be tweaked to make the process more efficient.

Recommended Reading:

Medicare Donut Hole

Are Hospital Discharged Dictated by Medicare Rules?

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