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Just reading about new Medicaid reimburs.

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  • Just reading about new Medicaid reimburs.

    Was just reading about the new Medicaid reimbursement to hospitals for inpatient tx.- a certain daily amount based on DIAGNOSIS. Let's see how this will impact the ongoing "debate" about the overdiagnosis of Bipolar D/O! (See Medscape wars!). There's certainly going to be some pressures for employed inpatient docs re. their dg. "choice"/charting.

  • #2
    There is a direct correlation between the frequency of a diagnosis and the amount of reimbursement for that diagnosis. Thus the diagnosis is no longer the diagnosis of the individual's disease but a diagnosis of the reimbursement schedule. As the reimbursement decreases the less the prevalence of that diagnosis. If all the diagnoses were no longer reimbursed there would be no more illness in this country!


    • #3
      Interesting, has anyone ever studied this? It would make a good case for the gov to rethink the whole reimbursement issue


      • #4
        Isn't this what they do with reimbursement for procedures? They cut the payment. Initially #procedures goes up as MDs try to maintain income. They keep cutting until they see the numbers decline - (meaning it's not worth doing anymore ) hence this is the sweet spot for Medicare, getting the rock bottom price.


        • #5
          >>It would make a good case for the gov to rethink the whole reimbursement issue<<

          That's exactly what they do in order to justify the reductions in THEIR minds.

          Rethinking amounts to the following. ....
          1. Are doctors still seeing patients? If the answer is yes, then they reduce payments until none of us will see the patients.
          2. When they get to the point that only non physicians are seeing patients, they will eventually cut their reimbursements also.

          Call me cynical



          • #6
            RJ we think alike. Nothing like applying free market rules on the payor side while rigidly controlling the provider side to PREVENT free market behavior.
            Simple, just follow the money.