The problem that is quickly coming onto the horizon is that your reimbursements (all of them) will be reduced if you don't have 95% of your diabletics with "good care." Your only recourse becomes to drop the patients or drop the insurer. This is what I have always not liked about the "pay for performance" trend in medicine. And even before this trend, the malpractice situation whereby if you don't document that you REPEATEDLY reminded the patient of the consequences of not going to that referral or taking that test, it becomes your fault. Because as soon as they have a "bad outcome" they are going to be mad and of course it is NEVER their fault for refusing to follow advice. At least in their mind.
