On Thursday, Jan 27, 4:30 PM Eastern, Medscape will participate in a roundtable discussion in our nation’s capital.
They will be bringing you the pressing questions about healthcare reform to the White House, and they're interested in hearing from you.
Visit Medscape.com to submit your question. Here is the text of my question:
"Evidence of overutilization of diagnostic imaging and specific surgeries implies that physicians and hospitals make treatment decisions based, at least partly, on financial gain.Do you have a question?
Many of these physicians are paid based on the volume of care they provide.
In 2014, hospitals will begin organizing Medicare payments into fixed payment (capitated) Accountable Care Organizations (ACO) which will be directed by the same group of physicians and administrators.
What mechanism will compel this group to switch from the current volume-driven model to a quality model?
One proposal I would like to make is de-centralizing the decision making to appropriately trained providers, like nurses, physician assistants and physical therapists.
Most of these professionals are paid a salary.
A mix of incentive-based physicians and salary-based professionals acting as primary care providers could prevent overutilization but also guard against "stinting" on care under the fixed-payment ACO model.
Physical therapists are not currently included as eligible professionals under Medicare Accountable Care Organizations (ACO).
Physical Therapists are trained to manage high-resource use chronic patients that tend to use lots of healthcare (doctor visits, hospitalizations and surgeries).
Physical therapists can keep these people in their homes - the lowest cost setting in all of healthcare.
I recommend including physical therapists in Medicare ACOs and decentralizing the decision making away from the "status quo".
Tim Richardson, PT
What would you like to see changed?
What do you think of healthcare reform?
Now's your chance to participate.
Go get 'em!