Monday, February 18, 2013

Physician reimbursement—or why you’ll wait, by Dr. Anna Meenan (retired at 54)

If you're wondering why your doctor is discouraged and depressed (and many are, though they don't show it) these days, this might help explain it:
As best I can tell, these are the rates paid by COMMERCIAL insurers. Medicare and Medicaid pay even less than this, and have also been lowering many of their rates. If you think that this is what goes into the doctor's pocket, you are wrong. Out of these sums, the doctor must pay all the overhead of running an office: skilled labor, equipment, supplies, utility bills, and thousands of dollars in malpractice insurance. Think for a moment about what you were charged the last time you called a plumber, or the last time you took your car in for repairs, and put the value of those services up against the value of your life and health. I'm just saying.

$86 for code 99215. Just to clarify, 99215 is the highest code for an office encounter. This is what your doctor would code if you came to his/her office with, oh, let's say, out-of control diabetes with a life-threatening electrolyte imbalance, or if a senior citizen was brought in who was suddenly very confused and not eating. 

Dr. Meenan graduated from the University of Illinois at Chicago, practiced in Rockford and formerly was with the medical clinic in Mt. Morris, Illinois


Anna said...

Unfortunately, the numbers for 2012 got cut off when the graph was posted to your blog. In descending order, those numbers are: $86, $70, $49, $32, $20. The numbers for 2013 will be even lower, if that is possible. During all this time, the doctors' cost of doing business has been increasing, not decreasing.

Norma said...

Thanks for the correction; I'll see if I can redo it. But it certainly explains why so many doctors don't want Medicare or Medicaid patients.