medicaid/care pts a hopeless case?

[Dr McSteamy]

Can ANY money be made from these people?
are there tangible or intangible benefits to be made from these people?

if you only spent 5 minutes max with these pts, is it somewhat worth it?

yes, i'm not ashamed to say, as a future doctor, I will only be looking out for myself.

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[GassiusClay]

Don't feel ashamed for thinking the obvious financially. You do a job that demands some form of real repayment meaning dollars. If the services rendered cost more than the reimbursement, then you are not going to stick that service. No one sells or does something at a loss unless it is expected to yield rewards in the near future. Operating at a loss is dumb, but the government somehow thinks that works.

So what will happen? More and more physicians will drop Medicare and Medicaid patients and send them to the big lines at county hospitals. Is it fair? Depends on who you ask. If you ask me, well don't be surprised getting in line if you are not going to pay out of your own pocket. It's not like food stamps buys 3 star restaurant food. Same goes for medicine. Yet food is not an essential right.

 

[Dr McSteamy]

i looked up a few things about medicare which i didn't know before.

medicare patients still have to pay some out of pocket.

Does that mean the combined out-of-pocket + government reimbursement = still a big loss for the doctor?

 

[deleted87716]

In general, you won't actually lose money seeing Medicare patients. You will not, however, have much of a margin.

Assuming you don't blindly sign every penny-ante commercial insurance contract that you encounter, Medicare will be pretty much the lowest payer in any practice, except for Medicaid. Medicare patients typically are older, have multiple chronic diseases, and require more time and resources than younger patients. Time is money, so the combination of high utilization and low reimbursement is something of a double whammy. Most doctors (at least, those of us who have a choice in the matter) limit the size of our Medicare panels to something less than 30% in order to maintain a more favorable payer mix and income.

Medicaid is another matter. In most cases, Medicaid reimbursement doesn't even cover your overhead. Doctors who accept Medicaid are essentially providing charity care. Most of us in private practice provide a certain amount of charity care one way or another. It doesn't have to be via the Medicaid system.

 

[Old_Mil]

Can ANY money be made from these people?
are there tangible or intangible benefits to be made from these people?

In my experience, at least, the typical medicaid patient is one that you have to try and save from him/herself. Lousy dietary/health habits, lousy life choices when it comes to allocation of resources (they never have money for medicines, but all of them have cable TV/a cellphone/one or more vehicles). They have bad/entitlement attitudes, are last in line to pay, are first in line to sue.

I don't much care for stereotypes, but when it comes to Medicaid, unfortunately most of them are true.

 

[montessori2md]

Here's what befuddles me:

1) Everyone, including people here on my part of the planet, say that seeing a medicaid pt is basically giving your time for free; and
2) I've had several MDs tell me they think the solution to US healthcare is to put everyone on medicare/medicaid.

How do these things go together?

The only cost savings I see is that all coding/billing goes to medicare, so that could theoretically save some $/time. And theoretically if everyone had insurance, you would see long term savings b/c more chronic conditions would be caught earlier, fewer ER visits, blah blah blah, but how would primary care docs pay their bills?