Health Care Reform: Medicare Implications

In a study published in JAMA earlier this month, the authors analyzed the health outcomes of 5,132,936 fee-for-service Medicare beneficiaries 65 years or older and compared them to the availability of 6,542 general internists and family physicians.  Broken down into quintiles, those who lived in areas with the greatest availability of primary care physicians had few hospitalizations & lower mortality, without any increase in spending per beneficiary, compared to those who had minimal access to primary care.

Given the multitude of issues at play with regards to health care reform, clearly one solution, amongst many, is to increase the primary care workforce.  How do go about doing this?  Decrease the cost of medical education and improve reimbursement for primary care.  It's that simple!

And in a rehash of a highly publicized article that appeared in the NY Times 2 years ago about the cost of care in McAllen, TX, we should also consider not just improving reimbursement for primary care but revamping the whole model whereby physicians get paid for caring more rather than just doing more.  As it stands, we're currently incentivized to do more just because we can, not necessarily because it's in our patients best interest.  Some of this can be blamed on our litigious society but not all.  Read the article if you haven't already.  It's an eye opener.