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Obamacare Stands


wagner
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I haven't read that link yet, but was talking to a Doctor who plays on our Soccer Team. He was very agitated at what was being put in place. He said his medical coding system is going to go from 200-400 Codes, to over 800 codes. Which means his time until he gets paid will be longer if something is coded invalid. He was also saying Women can't get mamograms until over the age of 50, but that 75% of the cancer cases he diagnoses, are women under 50, for breast cancer.

 

He went on to explain several other things, and basically saying in the end, this puts small/private practices out of business, as the administrative costs alone are going to be too high. As well as the care people will be receiving is actually below the current standard of care, solely due to the panels that will be appointed who get to pick and chose where the money is spent.

 

The conversion to ICD-10 was decided by the Bush administration in 2008. Bush also delayed full implementation from 2012 to 2013 The actual codes are published by the WHO and are used in multiple countries in the world. ICD-9 is almost 30 years old and needed some updating.

 

The numbers are a "bit" off too. There are currently about 13,000 codes, it is increasing to 68,000. His specialized practice will still use a small fraction of all those codes and be just fine after the initial learning curve.

 

What the Long Term Care industry found is that the more specific codes actually allowed them to increase their overall reimbursement rate. My knowledge of CMS is limited to that industry but it may be the same in acute and preventive care.

 

 

The Mammogram change is the result of a 15 year study that compared pros and cons of sub-50 mammograms. It is a recommendation put out by the U.S. Preventive Services Task Force, again separate from "Obamacare". Here is an article on the hype vs. reality: http://www.forbes.com/2009/11/19/mammogram-guidelines-cancer-business-healthcare-obamacare.html

 

What's this doctors name? I'm not a fan of getting medical treatment from doctors who mix punditry with fact.

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