Saturday, September 24, 2011

Medicare: Access to Mental Health Care in Danger

In many states, Medicare fees are at the bottom of the barrel, prompting physicians and other health care providers to stop accepting new patients or even to opt out of Medicare completely. A recent proposal from MedPAC (Medicare Payment Advisory Commission, which makes recommendations to Congress) would further reduce rates by up to 38% over the next 10 years.

I wrote an article yesterday in Clinical Psychiatry News explaining this critical danger to the health care safety net for seniors, baby boomers, and people on disability.

I think Medicare needs to reinvent its game by moving away from per-visit payments -- which reward volumes -- toward payments based on severity-adjusted episodes of care combined with quality and outcomes multipliers -- which rewards quality and efficiency.

By re-inventing the way Medicare pays all providers, not by quantity but by quality and efficiency, it has a chance to bend the cost curve without making it harder for beneficiaries to find a doctor who will accept Medicare. Medicare enrollees deserve to be treated better. If Congress messes this up, there will be hell to pay at the ballot box.
         Dinah added a post explaining what this might mean for patients at :