MCMS Physician Fall 2017 - 5

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noble goal, but it begs the question: how does penalizing
physicians for trying to address as many of a patient's
problems as possible during a single office visit better serve
the community? If we wish to improve population health,
shouldn't greater access be foremost on our minds? Shouldn't
we encourage said visits to be as robust and comprehensive as
possible, without financially punishing physicians for doing
so?
To be sure, the fee-for-service system has its flaws, and
at times has been abused. Payments for value and outcomes
are the future, and I am fine with that - so long as it helps
improve the health and well-being of patients. It's not just
the outcome but the process that matters. Imposing policies
such as the change to Modifier 25 and then expecting
physicians to simply 'buy in' is unrealistic, and puts the
shared goals of delivering better care for less cost at risk.
Insurers such as the one in question have a monopoly (not
to mention a powerful lobby), leaving the medical profession
powerless to fight policies such as these. And that leads to
burnout, followed by attrition. As a society, we seem to have
collectively forgotten that physicians are vital to solving
many of health-care's problems; instead, we are often treated
as their root cause. This needs to change, before we reach a
crisis point that is closer than many of us realize.

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Usually, when I write a column such as this, I end with
a solution. This time around, I am forced to admit I don't
have one. Sadly, Pennsylvania's Insurance Commissioner
has declined to get involved, citing the issue as "beyond the
scope of their office." The Pennsylvania Medical Society,
through tremendous effort, is working to try and get this
policy reversed, but as of today, it still stands. When and if
that changes is anybody's guess.
I don't like not having an answer, even if it ultimately
turns out to be the wrong one. I've been told that some
consider me a problem-solver, and failing to come up with
a suggestion for this one bothers me. Like an itch on your
shoulder blade that's just out-of-reach, it won't go away - yet
it is impossible to ignore. It is, like the news I raised at the
beginning of this column, maddening.
And no one likes to be mad. It's rarely a useful or
constructive emotion.

MCMS PHYSICIAN 5 FALL 2017

MCMS SPRING

2017.indd

MCMS

PHYSIC

our fees declin
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by health insur
ance comp
anies. My

IAN 8 S
PRING

2017

4/26/17

12:48 PM

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