Certainly we are all wrong. I mean the 10 ten insurance company CEOs averaged 15.2 million over 2016. They must know a lot.
That 99215 is crazy. This brings us right back to the entitlement and CMS debate. The closest thing we have to a union is the AMA, which is why I don't belong. They do nothing. Our Maine Medical Society hosts picnics all summer. Our MMA is pretty good. Lots of policy stuff. Free legal advice, etc.
I think much of this is it would be so hard to stage a Medicaid and Medicare sit out. If all of the physicians in Maine stopped treating MaineCare, it would be less than a week before the EDs had to shut down. But, they would just pull out license and that's it.
As far as concierge, it's very difficult for a practice making $35.00 for a 99213 or anything for that matter. Probably has to see 30 patients a day of which 70% are likely Medicaid because they get seen for free. But, for instance, if I switched to concierge, about 1350 patients would have to leave, because they aren't going to stay and pay cash. The issue is it would be a huge gamble. But, there's no going back. You can't in six months try to get all those MaineCare patients back.
I may be wrong, but I think part of the discrepancies are what the governor chooses to do. We made around 40% of Medicare (it is based on Medicare at least for us). He changed it to around 72%. He also turned down the Federal funds. Millions. But, those were for expansion. So you expand, then the government stops with the money and now you have more on MaineCare with less money. I wouldn't be making it except for this governor.
