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Doctors are being paid to make sure patients take drugs.
Rationalze it annnnnnnnny way you want, THAT is the FACT. And were you one of the people who said I was liar when I said my friend works for an insurance company that tracks and PAYS doctors to give patients drugs? I think so.
I also noticed you didn't acknowledge the other conditions that doctors are paid to ensure patients take drugs. That's in the document, too.
Doctors gets PAID to prescribe/ensure a patient takes drugs. It's all right there. No way around it suzyq. No way around it. Published by an INSURANCE COMPANY.
Payment schedule with algorithm to show how many patients that they need to get on/keep on the drugs. Some have a flat fee. Others are a percent of eligible patients.
AGAIN: Doctors are getting PAID to ensure their patient population is taking drugs.
You can post and post and post, but the BCBS doc is very clear.
You still don't get it. Doctors aren't rewarded for prescribing 1,000 of their patients a specific medication. They ARE rewarded if a PERCENTAGE of patients who NEED a class of medications because they have a DISEASE show IMPROVEMENT. They only get the incentive if the patient shows IMPROVEMENT on outcome measures. Again, not the raw number of people on drugs...but for those who need medication, the PERCENTAGE that IMPROVE. If a doctor overprescribes to people who don't need something and then they don't "improve" THEY DON"T GET THE INCENTIVE.
Nowhere is a specific drug or even generic mentioned. It is up to the doctor to prescribe whatever they think will work for the patient - again - the incentive does NOT depend on the doctor prescribing a certain drug - it is for positive outcomes. For example for hypertension:
Description
Members 18 to 85 years of age who were diagnosed with hypertension anytime on or before
June 30, 2016
Control is demonstrated by:
• Members 18 to 59 years of age with BP < 140/90 mm Hg
• Members 60 to 85 years of age with diagnosis of diabetes with BP < 140/90 mm Hg
• Members 60 to 85 years of age without a diagnosis of diabetes with BP < 150/90 mm Hg
The last blood pressure reading between July 1, 2016 and December 31, 2016, will be
counted.
Continuous enrollment Must be continuously enrolled with the same Blue Cross or BCN plan for 2016
Age criteria Members 18 to 85 years as of December 31, 2016
Numerator Members as defined above
Denominator The eligible populations
You still don't get it. Doctors aren't rewarded for prescribing 1,000 of their patients a specific medication. They ARE rewarded if a PERCENTAGE of patients who NEED a class of medications because they have a DISEASE show IMPROVEMENT. They only get the incentive if the patient shows IMPROVEMENT on outcome measures. Again, not the raw number of people on drugs...but for those who need medication, the PERCENTAGE that IMPROVE. If a doctor overprescribes to people who don't need something and then they don't "improve" THEY DON"T GET THE INCENTIVE.
Nowhere is a specific drug or even generic mentioned. It is up to the doctor to prescribe whatever they think will work for the patient - again - the incentive does NOT depend on the doctor prescribing a certain drug - it is for positive outcomes. For example for hypertension:
Description
Members 18 to 85 years of age who were diagnosed with hypertension anytime on or before
June 30, 2016
Control is demonstrated by:
• Members 18 to 59 years of age with BP < 140/90 mm Hg
• Members 60 to 85 years of age with diagnosis of diabetes with BP < 140/90 mm Hg
• Members 60 to 85 years of age without a diagnosis of diabetes with BP < 150/90 mm Hg
The last blood pressure reading between July 1, 2016 and December 31, 2016, will be
counted.
Continuous enrollment Must be continuously enrolled with the same Blue Cross or BCN plan for 2016
Age criteria Members 18 to 85 years as of December 31, 2016
Numerator Members as defined above
Denominator The eligible populations
Actually I get it just fine, thanks. Some people just refuse to see the truth. When it lists number of patients on drugs, adds in a weighted "star" system without any mention of patient outcomes, well yes, that means that doctors are getting paid to describe drugs. I never said "specific" drugs. I've said drugs.
Cognitive dissonance at its finest.
Disease modifying anti
-rheumatic drug therapy for
rheumatoid
arthritis
1
1
100%
5
5
Medication adherence for diabetes medication
s
(weighted x 3)
5
6
83%
5
5
5
5
Medication adherence for hypertension medication
s
(weighted x 3)
12
16
75%
3
3
3
3
Medication adherence for cholesterol medications
(weighted x 3)
20
24
83%
5
5
5
5
Tota l stars 78 Number of measures with a star score for Dr. A 17 Average star rating 4.59 Per - member - per - month payment $7.00 Dr. A’s 2016 member months 1,000 Dr. A’s total 2016 program dollars earned $7,000
I am truly sorry that you find the information at ProPublica so hard to understand.
None of the payments to doctors on the site are for prescribing medications. What you interpreted as payments for starting patients on drugs was payment for food, as is clearly described at the site.
Believe what you wish. It does not make it true.
Being a spouse of a doctor you should know, right?
Medication Adherence for diabetes management = Number of adult members 18 years or older enrolled during 2016 with at least two fills of medication across any of the drug classes (The percentage of adult Medicare members who adhere to their prescribed drug therapy across the following classes of oral diabetes medications; biguanides, sulfonylureas, thiazolidinediones, DPP-IV inhibitors, incretin mimetics, meglitinides, and SGLT2 inhibitors)
Medication adherence for hypertension medication = Number of adult members 18 years or older enrolled during 2016 with at least two fills of either the same medication or medications with the same active ingredient (the percentage of adult Medicare members who adhere to their prescribed drug therapy for ACEI or ARB medication)
medication adherence for cholesterol medication = Number of adult members 18 years of age or older enrolled during 2016 with at least two fills of either the same statin medication or medications with the same active ingredient. (The percentage of adult Medicare members who adhere to their prescribed drug therapy for statin cholesterol medications)
Flat fee payment for:
Members age 40 and over as of December 31, 2016, with a history of diabetes, cardiovascular disease or both who is prescribed or currently taking aspirin or antiplatelet therapy
Report CPT II code 4086F for all patients meeting criteria
Payments for patients on medications.
Now: If you are starting out as a doctor with $300K in med school bills, would you be swayed to get patients on meds/vaccines to boost your income? Some will, some won't.
Do you want the doctor who is listening to his insurance rep or the one who is listening to YOU?
Medication Adherence for diabetes management = Number of adult members 18 years or older enrolled during 2016 with at least two fills of medication across any of the drug classes (The percentage of adult Medicare members who adhere to their prescribed drug therapy across the following classes of oral diabetes medications; biguanides, sulfonylureas, thiazolidinediones, DPP-IV inhibitors, incretin mimetics, meglitinides, and SGLT2 inhibitors)
Medication adherence for hypertension medication = Number of adult members 18 years or older enrolled during 2016 with at least two fills of either the same medication or medications with the same active ingredient (the percentage of adult Medicare members who adhere to their prescribed drug therapy for ACEI or ARB medication)
medication adherence for cholesterol medication = Number of adult members 18 years of age or older enrolled during 2016 with at least two fills of either the same statin medication or medications with the same active ingredient. (The percentage of adult Medicare members who adhere to their prescribed drug therapy for statin cholesterol medications)
Flat fee payment for:
Members age 40 and over as of December 31, 2016, with a history of diabetes, cardiovascular disease or both who is prescribed or currently taking aspirin or antiplatelet therapy
Report CPT II code 4086F for all patients meeting criteria
Payments for patients on medications.
Now: If you are starting out as a doctor with $300K in med school bills, would you be swayed to get patients on meds/vaccines to boost your income? Some will, some won't.
Do you want the doctor who is listening to his insurance rep or the one who is listening to YOU?
Indirectly, they are selling medications!!!!! We pay or insurance pays which we pay for too.
Granted they don't have a cash register and a stock of meds in their office and you walk out with this and that, but sell us their meds they do via pharma.
Indirectly, they are selling medications!!!!! We pay or insurance pays which we pay for too.
Granted they don't have a cash register and a stock of meds in their office and you walk out with this and that, but sell us their meds they do via pharma.
The doctors aren't making any money from the prescriptions they write.
The doctors aren't making any money from the prescriptions they write.
The doctors are getting paid by the insurer for patients that they get on drugs and KEEP on drugs (must have filled 2 prescriptions to count that patient), and they can get $400 for ensuring each patient gets a combination of vaccines.
Read the pdf.
They ARE getting paid to ensure patients are prescribed and taking medications.
Do they sell the meds? Not the prescriptions, no. But they get paid if the patients fill the script 2x, and the only person who can write a script is the DOCTOR. Selling vaccines? Technically, yes. The vacs are bought and stocked in the office. You don't get them from the local CVS. That's on the doctor.
READ THE PDF.
Bottom line: Doctors get paid MORE by the insurance company for patients who are TAKING DRUGS.
Again: READ THE PDF. PREFERABLY BEFORE POSTING< SO YOU KNOW WHAT YOU ARE TALKING ABOUT.
Medication Adherence for diabetes management = Number of adult members 18 years or older enrolled during 2016 with at least two fills of medication across any of the drug classes (The percentage of adult Medicare members who adhere to their prescribed drug therapy across the following classes of oral diabetes medications; biguanides, sulfonylureas, thiazolidinediones, DPP-IV inhibitors, incretin mimetics, meglitinides, and SGLT2 inhibitors)
Medication adherence for hypertension medication = Number of adult members 18 years or older enrolled during 2016 with at least two fills of either the same medication or medications with the same active ingredient (the percentage of adult Medicare members who adhere to their prescribed drug therapy for ACEI or ARB medication)
medication adherence for cholesterol medication = Number of adult members 18 years of age or older enrolled during 2016 with at least two fills of either the same statin medication or medications with the same active ingredient. (The percentage of adult Medicare members who adhere to their prescribed drug therapy for statin cholesterol medications)
Flat fee payment for:
Members age 40 and over as of December 31, 2016, with a history of diabetes, cardiovascular disease or both who is prescribed or currently taking aspirin or antiplatelet therapy
Report CPT II code 4086F for all patients meeting criteria
Payments for patients on medications.
Now: If you are starting out as a doctor with $300K in med school bills, would you be swayed to get patients on meds/vaccines to boost your income? Some will, some won't.
Do you want the doctor who is listening to his insurance rep or the one who is listening to YOU?
You have been carrying on for some time now about the fortunes that doctors are allegedly raking in because they prescribe drugs that pharmaceutical companies want them to prescribe.
I looked into this a bit and found a website. Its called "dollars for docs".
I decided to type in the names of some physicians my wife and I have seen over the years for health problems. All told, I looked up about six doctors. It turns out that my family doctor earned the most out of all of them. Guess how much he made in three years? About $1,000.00. So, he has succeeded in supplementing his income by a total of about $330 a year from 2013 through 2015. The other doctors all got less than this. In fact, my wife's family doctor earned a total of about $57 from pharmaceutical companies during this same three year period. Oftentimes, the money is not paid in cash. Sometimes, it just takes the form of a meal at a restaurant.
I'd encourage anyone who thinks physicians are making a fortune doing this to type in the names of their own doctors. I think you will be amazed at just how little most are making from drug manufacturers.
NewtoVenice: You need to learn something about payments to physicians. The reality is that I believe there are abuses within the health care system too. I question the large salaries that some specialist physicians are earning. However, if you think all doctors are "paid off" to be in the hip pocket of companies like Merck, Pfizer, or Lilly you clearly don't know what you are talking about.
The doctors are getting paid by the insurer for patients that they get on drugs and KEEP on drugs (must have filled 2 prescriptions to count that patient), and they can get $400 for ensuring each patient gets a combination of vaccines.
Read the pdf.
They ARE getting paid to ensure patients are prescribed and taking medications.
Do they sell the meds? Not the prescriptions, no. But they get paid if the patients fill the script 2x, and the only person who can write a script is the DOCTOR. Selling vaccines? Technically, yes. The vacs are bought and stocked in the office. You don't get them from the local CVS. That's on the doctor.
READ THE PDF.
Bottom line: Doctors get paid MORE by the insurance company for patients who are TAKING DRUGS.
Again: READ THE PDF. PREFERABLY BEFORE POSTING< SO YOU KNOW WHAT YOU ARE TALKING ABOUT.
Yes, I got that. See markg's response above to learn how much they're getting paid. This is a program to keep people on their routine medications. You have no idea how hard it is to get people to take medications regularly. Some people feel it's a personal failing to have to take medications for blood pressure, cholesterol, diabetes.
Recommended vaccines must be provided for free at the point of service for people with ACA compliant insurance. Medicare B also covers vaccines. The doctors buy the vaccines from the drug companies, then get reimbursed by insurance. Many times they do not get reimbursed for the entire cost of the vaccine and administration.
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