Reimbursement based on patient satisfaction?

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Gauss

Damnit Jim!
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"The federal government's Centers for Medicare and Medicaid Services is finalizing a new reimbursement plan that will determine how hospitals get paid to take care of Medicare patients. The proposed rule calls for something called "value based purchasing," which is part of the health care reform law."
"Under the proposed rule, adherence to quality care measures will be weighted at 70 percent of the payment formula. Patient satisfaction surveys will account for the remaining 30 percent. "

http://www.pbs.org/newshour/rundown/2011/05/new-plan-aimed-at-improving-hospitals.html

Which will be linked to medicare's doctor rating website that went live earlier this year:
http://medicare.gov/find-a-doctor/

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reimbursement tied to patient satisfaction is probably one of the worst ideas i can imagine. patients dont like docs who tell them what needs to be said (you need to stop smoking, get into PT, or have a colonoscopy). you tie reimbursement to this, what you will get is a bunch of happy, unhealthy patients.

and this is aside of the whole opioid issue
 
reimbursement tied to patient satisfaction is probably one of the worst ideas i can imagine. patients dont like docs who tell them what needs to be said (you need to stop smoking, get into PT, or have a colonoscopy). you tie reimbursement to this, what you will get is a bunch of happy, unhealthy patients.

and this is aside of the whole opioid issue

amen... Government at its finest. Just stop taking medicare gradually, that is my solution.
 
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I will start recommending Big Macs and Hot fudge Sundaes to everyone.

Cigarettes are good for you and a pack a day at least will be my recommendation.

You should start with a six pack of beer per day, or the equivalent of your favorite spirits, but try to keep it under a 12-pack per day on weekdays.

You don't need those blood pressure or cholesterol pills. Here, take some vicodinsomaxanax instead.
 
The opioid problem will be a big issue.

If you do not give patients opioids, even if they are diverting/abusing it, one's "patient satisfaction" score will suffer.

Patient Satisfaction survey scores appear to be a ruse by hospitals/insurane companies/medicare to not pay physicians. It's ridiculous. You can't attach the right thing that needs to be done to a financial incentive.

As someone mentioned, usually the people that fill the surveys out are complainers. Also if a RN/MA bad mouths you behind your back, well guess what ...they will write that on YOUR survey.

When are we as physicians going to ban together on this and multiple issues? We can't just sit back on these issues.
 
Coming from a hospital-based primary specialty, I can already tell you what this is all about: If your scores are perfect you continue to get paid the same. If your scores, a.k.a "core measures", are anything less than perfect, your pay is cut. In practice, most everyone's pay gets cut some. It is simply a way to cut our pay while portraying to the media that they're doing something to increase quality of care for their own political gain. In fact, as stated so eloquently above, it does nothing more that create additional motivation for physicians to re-enforce patients most self destructive, self-indulgent, but most immediately "satisfying" behaviors. It's just more evidence of how we are allowing unneeded and unnecessary government involvement metastasize to the extent that it's destroying our profession and our country. When are we going to wake up and say "NO MORE"?
 
The opioid problem will be a big issue.

If you do not give patients opioids, even if they are diverting/abusing it, one's "patient satisfaction" score will suffer.

The only way I see around this is to not accept patients for opioids. Period.

Dont accept Medicaid either - they are universally unhappy people.
 
I tried prescribing opioids, but some of the PCPs wouldn't take the patients back after they were stable. They take their patients back from the cardiologist and write the BP cholesterol meds, but not the narcs. So now I provide non-narcotic alternatives and the honest ones say that's what they like about me. The others decline the referral when we tell them that they won't get scripts.
 
I tried prescribing opioids, but some of the PCPs wouldn't take the patients back after they were stable. They take their patients back from the cardiologist and write the BP cholesterol meds, but not the narcs. So now I provide non-narcotic alternatives and the honest ones say that's what they like about me. The others decline the referral when we tell them that they won't get scripts.

We need a thread specifically on non-narcotic pain practices so I'm going to start one now...


(I searched and no dedicated "non-narcotic pain practices" thread came up)
 
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