A Patient Advocate's View

Depending on the kindness of strangers.

Seniors depend more and more on Medicaid as they outlive their savings.  
Dr. Don McCanne of PNHP comments on this article which asks doctors to accept more Medicaid patients. 
Comment:  The expansion of Medicaid for low-income patients is one of the more troublesome features of the Affordable Care Act. Because of low payment rates, many physicians, especially high-income specialists, already refuse to accept Medicaid patients. Increasing the burden on those physicians who do accept Medicaid is apt to result in a pushback wherein access may be further impaired.
What can be done? Lawrence Cassalino has provided us with an excellent description of the dilemma, but I’m afraid that his 5% solution – physicians devoting 5% of their practices to Medicaid – will fail since it depends on physician professionalism, of putting patients first. After a career of trying to obtain specialized care for Medicaid patients, it was quite clear that that level of professionalism was not ubiquitous in my community, and I doubt that it is in most other communities. Relying on the pure goodness of physicians will not work because there are not enough so oriented to meet the need.
One important measure in ACA is the expansion of funding for federally qualified health centers. These centers improve access for vulnerable populations, though they still have difficulties obtaining adequate support of specialists. Today, the government announced a $150 million grant to assist these community health centers. $150 million? Unless the government becomes serious about community center funding, and unless something is done to attract specialists to support these centers, we cannot expect them to fill the void either.
There is a clear solution. We could establish a single payer national health program in which everyone has the same coverage and access to care. That may or may not renew the commitment of today’s physicians to professionalism, but at least it would create the appearance that patients would be placed first. For individuals considering a future career in medicine, professionalism would be a given.

November 8, 2013 Posted by | Uncategorized | , , , , | Leave a comment

You have to be in it to win it.

A leading physician practice management consultant called me today to ask about marketing a new Article 28 multi-specialty practice. I suggested to her that she look up the record on who was recently approved in NYS and to call them for their marketing plan. Are referrals still based on friendships or hospitall connections? Are Accountable Care Organizations or Insurance Plan Preferred Provider Organizations going to run the health care delivery system?

Here is the last chance for providers and others to be heard about how the ACA will be implemented in NYS. You or your organization can attend these meetings, no charge. lf you want your opinion in the record, make sure you put it in writing and send in advance or be there to testfy.
CON Redesign Special PHHPC Planning Committee,
PHHPC Committee and Full Council Meetings:
June – December 2012
6/21/12 – Albany Special Planning Committee: Driving Health System Improvement in New York State: Policy Priorities and Tools
7/25/12 – Albany Committee on Codes, Regulations, and Legislation
Committee on Public Health
Special Health Planning Committee: Innovations in Financing and Organizing Health Care: Implications for CON and Health Care Regulation
7/26/12 – Albany The Establishment and Project Review Committee
8/9/12 – Albany PHHPC Full Council
9/5/12 – Rochester Special Planning Committee: Regional Health Planning
9/19/12 – NYC Special Planning Committee: Establishment, Governance and Financial Feasibility
9/20/12 – NYC Regular PHHPC Committee
10/11/12 – NYC PHHPC Full Council
10/12/12 – NYC Special Planning Committee: Access and Public Need
10/30/12 – NYC Special Planning Committee: Review Draft Report
11/14/12 – Albany Special Planning Committee: Discuss Revised Report
11/15/12 – Albany Regular PHHPC Committee: Adoption of Report by Committee

Contact me if you have a question or comment. I get lots of comments on LinkedIn  groups from professionals in the field. How about letting the public in on our conversations,

July 16, 2012 Posted by | Uncategorized | , , , , | Leave a comment

The health system is changing before our very eyes.

We recently have a number of complaints from patients who have been stuck with large medical and hospital bills for things that used to be covered. Patients are going in for an ultrasound and being billed privately for use of the room. People are getting medications in the hospital and getting a gigantic co-pay bill because the medication wasn’t submitted correctly. As the health care system makes changes to protect themselves from the Affordable Care Act, how do patients make sure they have enough coverage? In this article, firefighters are questioning which coverage will be better, the one offered by the government to the public or the one they have for themselves?

July 10, 2012 Posted by | Uncategorized | , , , | Leave a comment