There must be a way to make some money on medicare patients cuz in senior areas, that's what their patient base IS.

I am sure the docs make less than they wish they did but they are not sleeping in their offices....yet.

Specialist lose money on Medicare/Medicaid. But, they have to accept them since their business is normally referrals from primary care docs. Primary care docs don't care about what type insurance someone has and if they have stop to ask before sending them to one specialist who will accept all patients verses one that only accepts private insurance, it is not going to happen. The way my gf handles it to reduce loss/make a profit is that she won't even see medicaid patients. Medicaid patients only have about a 60% rate of even showing up for an appointment. So, they overbook them. Even then, she has her RN see them. She only consults with the differential diagnosis.

Reimbursement gravy train is over.
Docs and hospitals are and will be forced to group up leading to fewer more powerful decision makers.
Siemens, Cardinals, GE and McKesson and a few others will be gobbling up all those below.
The whole industry is being geared for a completely data driven approach.
Volume based transition to so called quality based in order to keep sucking that gov tit
Is what it is...

Banditfist, what's your GF say about Tricare? I've seen what they pay on my statements and that looks like another money loser for the medical profession.

I know for a fact that the year after Obamacare passed, the insurance companies had BIG profits. That would have been 2010. They raised their rates and at the same time, people used their insurance less. Something about Obamacare passing had an effect on mass psychology.

FSA doesn't have the deductible problems that working people have so guess who is going to the doctor?

Trades wrote..

I know of a Chicago public works retiree that moved to Florida for the same reason.

California, Illinois, New York & the rest of the big public pension spender states better enact legislation taxing state & local pensions REGARDLESS of where the recipient lives.

Otherwise, they're going to just bleed out.

New Yorkers Leave Like East Germans Fled Communism
http://news.investors.com/article/613163....

Quote:

Big Government: New York thinks of itself as the place to be, but its high taxes have made it a place to flee. Those who have escaped the Empire State tax man could fill a major city.

From 1949 to 1961, more than 2.6 million of East Germany's 17 million population escaped to West Berlin or West Germany, a hemorrhage of humanity that led the Communists to construct the infamous Berlin Wall in 1961.

The state of New York, with about 19.5 million people, has no known plans to erect concrete barriers or barbed wire fences. But from 2000 to 2010 it suffered an exodus of some 3.4 million New Yorkers — nearly a million more people than in Germany's post-war experience and more than that of any other state.

And the outflow hasn't stopped. The income loss for the state is $45.6 billion, the Tax Foundation says.

Granted, it's not just one-way traffic. New York has plenty of immigration from abroad; its more than 4 million foreign-born residents give it the second-biggest immigrant population in America.

So net outward migration is about 1.3 million.

Most New York refugees are in sunny, zero-income-tax Florida. The Sunshine State, along with its rays, offer big relief from New York's state tax on income, which starts at almost 6.5% and reaches nearly 9% for the overly successful.

On top of that are high sales taxes that approach 9% in New York City, but 7% in some other areas.

New Yorkers who leave an estate of more than $1 million to their loved ones get hit with a state death tax reaching 16%, bringing billions into state coffers.

Democratic Gov. Andrew Cuomo admits that "working families can't afford to pay the ever-increasing tax burden ... and this state has no future if it is going to be the tax capital of the nation."

But like a long line of New York politicians from both parties, what he dangles is relief from the state's high property taxes, which are tied to state government spending mandates on localities — a longtime shell game showing no real signs of ending...

read the rest @ http://news.investors.com/article/613163....

Riceball's obgyn is probably suffering blowback from a similar Californiwhackistan exodus.

Anti wrote..

She was telling me about something she did for herself at home, a little dangerous, that had in the past been something that would have been done in a hospital.

I dunno, Anti - is her house saturated with MRSA (flesh-eating bacteria)? Maybe it was safer to do it at home...

I know for a fact that the year after Obamacare passed, the insurance companies had BIG profits.

Just wait until corrupt Obozocare fully kicks in.

No doctors, no patients. Paper-pushing puppeteers will get it all, or at least that's their plan.

Ifly:
To answer your question about my girlfriend treating Tricare patients: I asked her about this after your post. We live in Huntsville with Red Stone Arsenal here. We have a decent retirement population and with being in the South, have a higher than average military retirement pop too. She said that she loses more money on Tricare patients than Medicare/Medicaid patients, but feels that it is her duty to provide services to them. Red Stone doesn't have any real facilities or personnel that provide allergic or autoimmune knowledge.

Just had to post this:

My girlfriend had to turn away a patient who had an appointment to see her yesterday. Girl showed up and expected to not have to pay anything to meet with her. Even after reducing the upfront deposit of $500 to $150 to meet with her, this uninsure and unemployed patient demanded a free appointment. Gf's business manager is actually upset with my GF because even insurance will reimburse $160 for an office visit. But, it is a private practice and she can do what she wants.

20-25 million unemployed and underemployed + 15-20 million transitioned to HSA in last 5 years has made significant dent in medical services. Add medicare/medicaid squeeze. Also, people are becoming health conscious when they know they lose lot more with current insurance coverage. Insurance premiums are going up because healthy families are choosing HSAs and that leaves smaller and smaller pool of money to treat all the sick people in the group !

Anything that is not emergency or can be cured by itself can wait. And now you see Doctor getting in the arse. My first question to any doctor's office, lab or any medical services before I take it. "How much it will cost me ? " What codes will you be using? " Pl send me codes and state approved rate table or how much my insurance company will pay ?

Medicine is the only professional services in USA which has no defined standardized cost models. Insurance companies have to be in the middle otherwise this could get wild wild west very fast and potential for unthinkable frauds every where.

At the city commission meeting Thursday evening, the contract renewal for the city's medical insurance consultant was renewed. The consultant commented that the price increases for medical care caused by Obamacare will not be nearly the problem as the compliance issues.

Heck, my brother-in-law is a master plumber with his own business. He has had to hire extra help to deal with the added paperwork and still has to spend more of his own time on compliance demands.

Quote:

Insurance companies have to be in the middle otherwise this could get wild wild west very fast and potential for unthinkable frauds every where.

Ok, we already have fraud every where.

Quote:

He has had to hire extra help to deal with the added paperwork and still has to spend more of his own time on compliance demands.

And this help is for a non-productive (meaning it does not help the company grow or your BIL to achieve his goals) employee. I'm sure he'd rather hire another laborer which produces income for the business.

Dwedeking,

Bingo on both counts.

Can anyone give and idea of what the "compliance" entails?

Why can't your BIL just as for an exemption like all the big businesses do?

A doctor does NOT have o accept medicare or medicaid. But if they do not "accept" it and see a medicare patient on an emergency basis, for instance at the hospital, then .gov sends the check to the PATIENT and the doc has to bill the patient and get their payment from the patient.

You can imagine how that goes...a large percentage of patients get the check and spend it and then either don't pay the doc at all or figure out a payment plan.

Watch Oregon this fall. The FEDs are giving the state several billion to run medicaid and some medicare plans. The state has formed "ACO's" or "CCOs" on a county by county basis. The CCOs will have boards dominated by Primary care docs and hospitals...which is not exactly a bad thing. I am hearing certain drugs and procedures will be "non formulary".

For instance:

No more hernia surgery unless it is incarcerated
No more varicose vein surgery
No more second line therapy for lung cancer....

and it goes on and on.

Society has sort of given the administrators a "dual mandate": stop spending so much money on health care...but keep the miracles coming in. I think the former is more likely as people are really getting tired of the massively escalating costs.

Quote:

Nope. Four hours in the hospital for 7 stitches - god knows how much $.

I just got 6 stitches in the ER last month. Total bills I've seen so far are over $2100. While in the ER, I told the doctor I would be removing my own stitches because I wasn't about to pay someone else to do it. He rolled up a couple of medical utensils in a paper towel and handed it to my wife... "Put this in your purse. I didn't give it to you"

The Oregon experiment should be interesting. This is not the first time for Oregon to try something similar. IIRC, community-acquired pneumonia in the elderly that was nonresponsive to oral antibiotics was considered for inclusion on that list of noncovered diagnoses.

Geez, Azusman, that was my Father's diagnosis. He had a lot of good years left in him after he pulled through. He was sharp as a tack until the day he died. He worked two careers, both offering lifetime health insurance to make sure he and Mom weren't a burden to us.

These kinds of discussions make me glad he's gone. He got a bit less than he earned and was promised but more than any of us will get. Maybe it is choices like these which will make it untenable for immigrants to come here and bring grandma over to babysit and eventually die on the public dime and all the other myriad abuses which have been noted.

I'd rather have the 1950s system back - as much health care as you want and can pay for.

Just got a letter from a local hospital doctor that he will no longer treat patients from June 30. I assume that he was fired and this indicates to me that this particular hospital is reducing its staff.

New local hospital (Riverbend in Springfield) is facing a nursing strike. Cutting hours, cuttings staff, raising health insurance costs for them (the nurses).

One of the major hospital groups in our area just built a brand-new Taj Mahal of hospitals in the suburbs as their main campus, and have diminished or outright ended services at their outpost campuses. Cost overruns created a cash-crunch, and it was a distinct possibility the hospital would go bankrupt soon after opening.

Fast-forward 3 months (to today) and the cash-crunch is "nearly over" but the local newspaper ran an article that the private birthing suites in the gleaming new facility are very popular with the new mothers from the City of Trenton (where the old facility was closed). Few have insurance. So the overpriced hospital now has a top-of-the-line birthing hotel for the FSA of Trenton, covered by Medicare and charity care, ultimately paid for by the taxpayers. Love it. Embrace it. This is the future.

This article in the LA Times*****ed me off when I read it:
http://articles.latimes.com/2012/may/27/....

Quote:

Many hospitals, doctors offer cash discount for medical bills
HEALTHCARE’S HIGH COST

The lowest price is usually available only if patients don't use their health insurance. In one case, blood tests that cost an insured patient $415 would have been $95 in cash.

Jo Ann Snyder, 57, was shocked when she found out how much her medical bill would have been if she had paid cash. “I couldn’t believe it,” said Snyder, manager of a Seal Beach hair salon. “I was really upset that I got charged so much and Blue Shield allowed that. You expect them to work harder for you and negotiate a better deal.”

Jo Ann Snyder, 57, was shocked when she found out how much her medical bill… (Bob Chamberlin, Los Angeles…)

A Long Beach hospital charged Jo Ann Snyder $6,707 for a CT scan of her abdomen and pelvis after colon surgery. But because she had health insurance with Blue Shield of California, her share was much less: $2,336.

Then Snyder tripped across one of the little-known secrets of healthcare: If she hadn't used her insurance, her bill would have been even lower, just $1,054.

wild_willy - the last vestige of anything resembling a free market (doctors & patients freely negotiating a price)*****es you off?

explain.

btw, people here have been writing about the lower prices you can get paying cash & shopping around for years on this forum...the only reason the insured price is higher in the first place is EMTALA, Medicaid/Medicare, various cost-shifting and medical industry lobbied for the right to price discriminate based on method of payment.

Actually, Wild_willy's story is the first I have heard of cash BEATING the reduced insurance amount.

Labs around here won't even let you pay at the door - submit your information then get the screw-u bill later.

Fortunately my interaction with medical care has been non-existent for over two years and I intend to have no interaction with that broken system ever again.

Quote:

Actually, Wild_willy's story is the first I have heard of cash BEATING the reduced insurance amount.

Our daughter had an ER visit on the same day she signed the paperwork for her health insurance. Since she didn't know whether the insurance would be effective, she arranged to pay cash. As I recall, the total was about $1200. Then she found out the insurance was effective on that date, and gave the insurance info to the hospital. They came back and said she owed $1400 because of the deductable. They refused to honor their original cash quote.