Fight over Medicare pay hinges on primary care

Interesting that a new diagnostic code set to unveil on Jan 1, 2024 could boost Primary Care doctor’s pay at the expense of specialists. Lobbyists are not amused.



The code will have two major affects.

One PCP care will increase over time as pay increases and some young medical doctors do not need to specialize necessarily for pay.

Two more specialists will go to private care for cash instead of accepting Medicare.

The first affect matters to opening care to everyone. The standard of care in the US will rise. The second will deny many average income people better care.

This is like the debate over raising the minimum wage. The people who are barely up the income ladder resent it because those lowly folks will be equal. It is a self centered nonsense argument.

The specialists will make more money. The reason those who stay with Medicare will carve up the pie among fewer specialized doctors. Those who go private only will make more money.

I seriously doubt either of those two scenarios will happen.

Medicare …and a number of group health plans…already have procedure codes that allow PCPs to bill for the extra admin/financial burden that patients with multiple comorbidities place on a practice under the codes for Chronic Care Management. I’ve written about it on this board along with the Health Related Finances board (easy to find on that barely active forum) and cross posted to the LBYM board at the same time. Have you seen any “fights” over this extra pittance maybe finding its way into PCPs’ offices? I suspect not. I can see little to no reason this one extra attempt at fair compensation will raise any more interest.

Knowing what practices (and possibly patients) will likely need to do in order to be compliant with billing under this code, it’ll be more trouble than it’s worth.