Trump’s Payment Proposal Would Pay Doctors Flat Fee

trump standing over paperwork over blue background

The Trump administration is proposing a change to the way Medicare pays doctors. There are five levels to an office visit with most doctors. These visits are coded based on how much time the doctor spent with the patient, the level of care provided, and whether or not the visit was with a new or existing patient. The higher the level of the office visit, the more a patient is charged. But the Trump administration is trying to pay doctors using a flat fee. Here are some pros and cons of the payment proposal.

Payment proposal pros

One major pro of the payment proposal is that it would cut down on the amount of paperwork doctors need to do. This is due to the fact that doctors would not have to spend time coding each appointment and doing lengthy paperwork for each patient and each service provided.

In that case, the payment proposal would effectively increase the amount of time doctors can spend providing each patient with care. When you remove lengthy paperwork from the mix, it improves the health of the patients.

However, it would only cut down on about 51 hours of work per year, or about one hour per week. Some argue that the benefits don’t outweigh the cons.

Payment proposal cons

There are several cons to this payment proposal. First, critics fear it would underpay doctors who care for patients with the greatest medical needs and complicated health problems. For example, doctors would be paid the same for a patient who had the flu compared to a person with stage 4 breast cancer. This could discourage doctors from taking on patients who need a lot of care, specifically Medicare patients who might have chronic and complicated illnesses.

Second, the payment proposal could increase the risk of fraudulent payments because doctors would be submitting less information to document the services provided to the patient. This system would be hard for federal auditors to track services and payments. Federal auditors have found that improper billing and fraudulent payment costs Medicare billions of dollars per year, and this new system could increase that number drastically.

Third, it could decrease the number of doctors willing to see Medicare patients and increase wait times for those who need to see specialists.  This would effectively harm health outcomes for Medicare beneficiaries, something healthcare advocates are very aware of when discussing this new payment proposal.

Trump’s proposal is part of Medicare’s physician fee schedule for 2019. The proposal is published early so that the public has a chance to comment on it before it comes to a vote on September 10. The new policies would effectively start in January. If you feel strongly about this payment proposal, contact your state representatives.

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