The Obama administration wants to dramatically change how doctors are paid
Source: Washington Post
The Obama administration on Monday announced an ambitious goal to overhaul the way doctors are paid, tying their fees more closely to the quality of care rather than the quantity.
Rather than pay more money to Medicare doctors simply for every procedure they perform, the government will also evaluate whether patients are healthier, among other measures. The goal is for half of all Medicare payments to be handled this way by 2018.
Monday’s announcement marks the administration’s biggest effort yet to shape how doctors are compensated across the health-care system. As the country's largest payer of health-care services, Medicare influences medical care generally, meaning the changes being initiated by the administration will likely be felt in doctor's offices and hospitals across the country.
“As a very large payer in the system, we believe we have a responsibility to lead," said Health and Human Services Secretary Sylvia Mathews Burwell in a press conference. "For the first time, we’re going to set clear goals and establish a clear timeline for moving from volume to value in the Medicare system.”
Read more: http://www.washingtonpost.com/blogs/wonkblog/wp/2015/01/26/the-obama-administration-wants-to-dramatically-change-how-doctors-are-paid/
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can't have Obama doing something else great after you have denigrated him so badly!
By the way....,Obamacares is coming in 20% cheaper than anticipated.....according to the CBO...
right????
Measuring value accurately, efficiently and cheaply may be easier said than done.
Another factor that deserves consideration are the possible unintended consequences regarding incentivization if compensation is tied to outcomes.
The incentives to treat patients with multiple medical issues and with uncertain or poor prognoses will change in ways that may not necessarily be in line with our ideals of humane care.
It also sounds like such a system would also continue to increase the amount of resources devoted to attempting to document that a patient has documented issues which result in higher compensation. (That assumes that outcome measurement adequately and accurately takes consideration of sicker patients generally worse prognosis, and increases compensation accordingly, which will be difficult to measure. If this is not the case, (and compensation not adequately increased for such patients, then the clear incentive would be for providers to avoid sick patients, and those with poor social support systems or other factors that worsen their prognosis, like the plaque.
I agree with you that the place to start would be changing incentives so that cognitive skills are more highly paid, with less incentivization of resource-intense tests and procedures. Doing this would improve quality while lowering costs, and would avoid the possibility of perversely altering incentives as above.
I agree! Medicare doctors are becoming fewer and fewer and ones that do accept Medicare are taking no more patients and have closed their practices to them. This is not good!
And where are all of those "Medicare for All" cries now? I hear none.
Some people that are disabled are on Medicare.
I have PPMS (primary progressive MS). There is nothing that can be done for me. I know this and my doctor knows this.
What are they going to do in a case like this (and I am sure there are many others out there that are on Medicare, totally disabled with a poor/negative prognosis)?
Just go home and die is what I pick-up, and the sooner the better. 
"my brother's warden."
(That's how I interpret "keeper."
That's already happened in many school districts: If a student fails, it doesn't matter--it means the teacher has failed. Teachers are their student's wardens, their custodians. If a student screws up, accountability falls on the teacher. At least it used to be the parent that was responsible for a kid's screw ups. After all, they have the authority to do something about it.
So now they want a doctor to be responsible for forcing his (her) patients to live healthier lives, stick to their prescriptions, seek follow-up care, and follow doctor's recommendations and orders? And, of course, if they manage to compel doctors to do that, politicians will take the credit. It's all about taking credit for what you force other people to do or what you do with their money.
I know: How about we first do that with lawyers and politicians. Lawyers are held responsible for what their clients do. A lawyer gets a client off who goes and kills somebody, it's that lawyer's responsibility. A politician passes a law that doesn't work out, the politician is held completely responsible for it and can be personally sued in a class action suit. A politician's appointee screw's up, it's really that politician's failure and his (her) personal or election finances have to make the electorate whole.
Our society hasn't failed, it's the politicians owned by the billionaires that is starting to fail.
Having fun with social media that goes around the status quo electronically really must erk a few of those well heeled folks 
because they're going to judge doctors on outcomes that don't directly control
Fine. But then that faces the same problem the argument against outcome-based assessment in education does: if you can't actually say person A will reliably have better outcomes than person B, why does it matter who's a doctor/teacher? Just grab somebody to do both for minimum wage, since by your argument it doesn't matter who does it.
including young disabled people and the very elderly.
Thank you for trying to educate. And good luck and warm wishes for you and your daughter.
