Daily Editors' Notes

Docs might get a raise, and long-term care might get a bill

Share this article:
John O'Connor
John O'Connor

Major League teams don't celebrate World Series victories midway through the season. But politicians do the equivalent all the time. Consider a revised Medicare payment plan that was joyously unveiled on Thursday.

As McKnight's reported, bipartisan leaders from the Senate and House announced a two-pronged way to replace Medicare's Sustainable Growth Rate formula for physician payments.

The SGR repeal and a newly minted Medicare Provider Payment Modernization Act (H.R. 4015) would collectively ensure a 0.5% payment update for five years. If you're a physician, that has to look a whole lot better than the 27% pay cut that was about to kick in.

In addition, the system for physician-quality reporting would be consolidated. So would the electronic health record and value-based modifier programs. The agreement also mentions that the bill “implements a process to re-base misvalued codes” and “requires development of quality measures in close collaboration with physicians.”

To be fair, this compromise will likely prevent many doctors from fleeing the Medicare program. That's all but certain if major Medicare funding reductions are carried out. And barring yet another patch on the so called “doc fix,” that was about to happen.

But there are a couple of teeny little problems with the proposed fix of the doc fix. One is that the agreement fails to address how all this new wonderfulness will actually be paid for. Nor does the proposed legislation include funding for a package of Medicare policies — known as extenders –— that fund therapy services.

If you are a long-term care provider worried that you'll eventually be paying a price for this agreement in principle (via reduced Medicare funding), you have a legitimate concern.

To further complicate matters, it does not appear that the proposed legislation is what you might want to call healthcare-reform friendly. Many of the people familiar with its particulars have concluded that it would introduce byzantine clinical record keeping rules, while retaining incentives for physicians to maximize services.

So to sum up, our lawmakers have announced a plan without determining how to pay for it. They will very likely cut reimbursement to long-term care operators once the numbers actually need to be dealt with. And by the way, healthcare may become more complicated and costly as a result.

Yes, the so-called doc fix may get resolved. But it appears long-term care operators may get fixed in a way that's more familiar to veterinarians.

Share this article:

Daily Editors' Notes

McKnight's Daily Editor's Notes features commentary on the latest in long-term care news. Entries are written by Editorial Director John O'Connor on Monday and Friday; Staff Writer Tim Mullaney on Tuesday, Editor James M. Berklan on Wednesday and Senior Editor Elizabeth Newman on Thursday.

    ALL MCKNIGHT'S BLOGS

    More in Daily Editors' Notes

    Using the Internet to reduce depression

    Using the Internet to reduce depression

    When I saw the headline "Internet use can help ward off depression among elderly," I figured it was an article written by the owners of It's Never 2 Late, Linked ...

    A jolt to long-term care best practices, amid the Ivy

    A jolt to long-term care best practices, amid ...

    This is going to sound terribly wrong on the face of it. There's no way around it. It appears that the nation's largest association of nursing home operators has just ...

    Is 'person-centered care coordinator' the next must-have staff member?

    Is 'person-centered care coordinator' the next must-have staff ...

    Long-term care operators take note: You soon could fail residents, anger family members, increase survey deficiencies, drop Nursing Home Compare stars and lose money unless you hire a Coordinator of ...