More Doctors are now taking medicare than accepting private

MagsterMile · Post by **MagsterMile** » Sun Sep 08, 2013 7:53 am

I go to a Dr. affiliated with a major hospital chain in my area. All the Dr.'s there I've checked into are accepting Medicare patients as well as Medicaid patients.

I got a weird letter yesterday from my insurance company, Humana Medicare Advantage. They want to send a Dr. out to my house to do an assessment they will: check my breathing - check my bp and pulse - monitor my breathing - get a brief medical history. Oh, the visit is supposed to take 90 min. They claim they are sending the results to my family physician. I'm thinking they are pulling this stunt so I don't need to get a yearly exam at the Dr.'s office. The letter head says its from Humana. But, being the suspicious person that I am, I will call Humana to find out what this is all about. Has anyone else received this type of letter?

Pugsy · Post by **Pugsy** » Sun Sep 08, 2013 8:46 am

MagsterMile wrote:Has anyone else received this type of letter?

I got a similar notice (and a phone call) from my Medicare Advantage carrier (not Humana) about sending someone out, but no mention as to the person being a doctor, for a home check up and discussion about meds or whatever.
I politely declined. To me that is an invasion of my privacy...I don't need or want some stranger coming to my home.
I am quite capable of managing myself with my PCP office visits.
I don't think it is something that is done to get out of paying for a doctor....it is offered maybe as a wellness thing as a policy benefit and I guess it might be useful for someone who doesn't see a doctor regularly or is maybe getting a bit senile or maybe they are just plain nosy. I don't/didn't like the idea and I don't think it is any of their business what my meds are or when I take them or anything else related to my personal situation.

oak · Post by **oak** » Sun Sep 08, 2013 8:58 am

Pugsy wrote:
..it is offered maybe as a wellness thing as a policy benefit and I guess it might be useful for someone who doesn't see a doctor regularly or is maybe getting a bit senile or maybe they are just plain nosy. I don't/didn't like the idea and I don't think it is any of their business what my meds are or when I take them or anything else related to my personal situation.

I have a funny story to tell about this. I had the above as a "benefit" with my BCBS insurance and they told me they wanted to come to my house. I asked why and the nurse went into great detail about my medical condition, including pressure sores, lack of mobility, and other fun things. Seems she had the wrong diagnoses lined up with the wrong patient. I told her I could manage my medical care quite adequately with my doctor and was just then leaving for an appointment. She said, "oh, you DRIVE?" We then got into a discussion about how I drove several hundred miles per week for my job. Needless to say, she was quite embarrassed.

Good old "managed care." Just to save the insurance company money. That's all managed care is. I say that from working in the insurance industry with injured workers for many years. Its supposed to save money and it actually wastes money.

hyperlexis · Post by **hyperlexis** » Sun Sep 08, 2013 9:10 am

oak wrote:I don't believe for a minute that when baby boomers are all on Medicare that there wont be GOOD doctors to treat them. The numbers of baby boomers alone will dictate that doctors be willing to treat them. Now my sons' generation is another story entirely.

Agreed. But I don't get the point of the OP anyway. OK so more doctors take medicare than private insurance? Or maybe there are just more sick old baby boomers out there on Medicare going to the doctor. Or maybe no, maybe more doctors take private insurance?

Who cares. It's almost a distinction without a difference. Should doctors not take Medicare? Should they not take private insurance? I don't get the point.

In the wonderful, twisted, backwards world of U.S. healthcare reimbursement, it's all just a means to an end. As long as there is a buyer (a patient) with a means to pay for a doctor, be it through Medicaid, Medicare, Tricare, Private insurance, or even cash, some doctor will fill the role. If we hail the free market as our sovereign, then that's the way things work out. If there's a need, someone will fill it. It's why every American town with more than five people has a McDonalds and maybe even a Starbucks.

The goal is to try and increase the number of MDs out there in general family practice, of which, the US has a paltry amount, because specialists can charge more. Thankfully under the new ACA, there is a lot of funding and programs now to help increase the number of medical school graduates going into family medicine/general practice. And that's a very, very good thing....

hyperlexis · Post by **hyperlexis** » Sun Sep 08, 2013 9:35 am

Pugsy wrote:
MagsterMile wrote:Has anyone else received this type of letter?
I got a similar notice (and a phone call) from my Medicare Advantage carrier (not Humana) about sending someone out, but no mention as to the person being a doctor, for a home check up and discussion about meds or whatever.
I politely declined. To me that is an invasion of my privacy...I don't need or want some stranger coming to my home.
I am quite capable of managing myself with my PCP office visits.
I don't think it is something that is done to get out of paying for a doctor....it is offered maybe as a wellness thing as a policy benefit and I guess it might be useful for someone who doesn't see a doctor regularly or is maybe getting a bit senile or maybe they are just plain nosy. I don't/didn't like the idea and I don't think it is any of their business what my meds are or when I take them or anything else related to my personal situation.

Dear Pugsy, I appreciate your opinions very much and you obviously have a strong ability to manage your own health and whatnot, but honestly, I think you are wrong in this instance, on the broader, macro level. My dad is on a Medicare Advatage HMO and I have gotten those calls for him too.

I have no problem with those folks inquiring and sending out a nurse or counsellor, on, OBVIOUSLY a confidential basis, out to meet because it's really a great added benefit of the insurance. I'd love free housecalls from my BCBS PPO....

While you and I are pretty up on our healthcare needs, etc., do you realize how many millions of Americans, especially the elderly on Medicare, are not? It's why diabetes and high blood pressure and heart disease and all their related conditions are so prevalent. People simply mismanaging and not controlling chronic conditions is one of the biggest drivers of U.S. healthcare dollars. My dad, for one, I know is on large handfulls of expensive daily pills for a myriad of conditions. It's ridiculous what his GP has him on. When one of my friends, a young MD, reviewed the entire list he was upset because so many of the drugs were duplicitave of each other. He said your dad should basically be on insulin at this point because the pills aren't working, and dad's sedentary life isn't helping either. But dad's GP (really a rheumatologist doing internal medicine) says nothing is wrong.... I would love to get another opinion, a fresh set of eyes, from an MD, a nurse or someone, to review his treatment plan and all those drugs! Just to get a suggestion, like what some pharmacies do, that hey, maybe this or that drug combo should be re-reviewed for effectiveness and cost for this patient.

Multiply my family's scenario times millions and millions of Americans in similar (or worse) situations, and one can see how it really could help people better manage their care, and yes, definitely save them personally, and Medicare some money -- and that is definitely good for everyone.

I hope Medicare keeps pursuing this benefit for every Medicare enrolee or Medicare Advantage participant too.

oak · Post by **oak** » Sun Sep 08, 2013 9:47 am

Hyperlexis, IMHO, in theory its a good idea. After 15 years of working in managed care in various settings, including in-home visits, clinics, and hospitals, I can tell you that the system is broken and the object is no longer the benefit of the patient. It is purely for cost containment and it doesn't even do that very well.

Which is too bad, because there are alot of people like your father and we baby boomers are going to create a huge need in that area.

I would advise you to call his insurance; there may be a benefit of that type which could help your dad in some small way. Another option of course is to find an in-network geratric physician who would do a complete physical and systems review. You could request a complete medication review as part of it (and of course, you or another family member would have to be present). We did this at Mayo some years back with my sister and it was amazing seeing integrated care at work.

Good luck.

chunkyfrog · Post by **chunkyfrog** » Sun Sep 08, 2013 9:55 am

As long as I don't need it, I would prefer to not take away from those who are not as mobile as I.
Patients who want and need the service are welcome to it; for me it would be a waste of resources.
With the large numbers of younger, healthier (?) Americans qualifying for Medicare,
The good business model for doctors would be to take new Medicare patients.

Pugsy · Post by **Pugsy** » Sun Sep 08, 2013 10:05 am

hyperlexis wrote: but honestly, I think you are wrong in this instance, .

I am not wrong because there is no right or wrong IMHO. It's personal choice and what a person is comfortable with allowing in their own home.
Maybe you are okay with a stranger coming to your home poking around in your personal life but I am not.
I am also not comfortable with sharing personal information with anyone but my own doctor. If my insurance company feels the need to delve into my personal situation then they can talk to my doctor.
I am home alone probably 6 nights out of 7 a week. I don't want a stranger knowing that fact...you never know what crazies are going to be out there and don't go telling me that all health care employees are trustworthy because we all know that crazies are everywhere.

Besides...there's no guarantee that I even will keep the current insurance company each year...why would I want personal information on file with some place I no longer want to do business with?
Home visits are not required to get or keep the insurance...to me it's an invasion of my privacy that I have not initiated so it is unwelcome.

It's a personal choice as to whether anyone wants to share anything with anyone else and I choose not to.

hyperlexis · Post by **hyperlexis** » Sun Sep 08, 2013 10:24 am

Pugsy wrote:
hyperlexis wrote: but honestly, I think you are wrong in this instance, .
I am not wrong because there is no right or wrong IMHO. It's personal choice and what a person is comfortable with allowing in their own home.
Maybe you are okay with a stranger coming to your home poking around in your personal life but I am not.
I am also not comfortable with sharing personal information with anyone but my own doctor. If my insurance company feels the need to delve into my personal situation then they can talk to my doctor.
I am home alone probably 6 nights out of 7 a week. I don't want a stranger knowing that fact...you never know what crazies are going to be out there and don't go telling me that all health care employees are trustworthy because we all know that crazies are everywhere.

Besides...there's no guarantee that I even will keep the current insurance company each year...why would I want personal information on file with some place I no longer want to do business with?
Home visits are not required to get or keep the insurance...to me it's an invasion of my privacy that I have not initiated so it is unwelcome.

It's a personal choice as to whether anyone wants to share anything with anyone else and I choose not to.

Well now a lot of people on the Internet who are not medical people know you live alone.....

If you don't want someone in your house that's your own deal.

But the program itself isn't bad because you happen to have those personal issues.

In fact, its a great program.

oak · Post by **oak** » Sun Sep 08, 2013 10:52 am

hyperlexis wrote:
Pugsy wrote:
hyperlexis wrote: but honestly, I think you are wrong in this instance, .
I am not wrong because there is no right or wrong IMHO. It's personal choice and what a person is comfortable with allowing in their own home.
Maybe you are okay with a stranger coming to your home poking around in your personal life but I am not.
I am also not comfortable with sharing personal information with anyone but my own doctor. If my insurance company feels the need to delve into my personal situation then they can talk to my doctor.
I am home alone probably 6 nights out of 7 a week. I don't want a stranger knowing that fact...you never know what crazies are going to be out there and don't go telling me that all health care employees are trustworthy because we all know that crazies are everywhere.

Besides...there's no guarantee that I even will keep the current insurance company each year...why would I want personal information on file with some place I no longer want to do business with?
Home visits are not required to get or keep the insurance...to me it's an invasion of my privacy that I have not initiated so it is unwelcome.

It's a personal choice as to whether anyone wants to share anything with anyone else and I choose not to.
Well now a lot of people on the Internet who are not medical people know you live alone.....she didn't say she lives alone

If you don't want someone in your house that's your own deal.exactly

But the program itself isn't bad because you happen to have those personal issues. there is no "program". This is an initiative different insurance companies have used in trying to save money.

In fact, its a great program.

Again, there is no "program." Company A might do a better job than company B, but I can tell you from experience that they both have the same objective and its not helping the patient. Sorry to sound so negative but its trueWhy dont you "try it out" with your dad if available with his insurance or supplement, and get back to us when you have had firsthand experience?

Pugsy · Post by **Pugsy** » Sun Sep 08, 2013 11:07 am

hyperlexis wrote: But the program itself isn't bad because you happen to have those personal issues.

Hey....where did I say it was a bad program? Someone ask if anyone else had got a similar notice offering such a home visit and I responded that I did get a similar notice and explained why I declined.
Please don't put words in my mouth that I didn't say...fair enough??? I never said it was bad. I get real testy when people do that.
Notice the "I" and the "my"...
I don't see "bad" anywhere in my statement about my own personal feelings about what was being offered. Do you see it anywhere below???

Pugsy wrote: I got a similar notice (and a phone call) from my Medicare Advantage carrier (not Humana) about sending someone out, but no mention as to the person being a doctor, for a home check up and discussion about meds or whatever.
I politely declined. To me that is an invasion of my privacy...I don't need or want some stranger coming to my home.
I am quite capable of managing myself with my PCP office visits.
I don't think it is something that is done to get out of paying for a doctor....it is offered maybe as a wellness thing as a policy benefit and I guess it might be useful for someone who doesn't see a doctor regularly or is maybe getting a bit senile or maybe they are just plain nosy. I don't/didn't like the idea and I don't think it is any of their business what my meds are or when I take them or anything else related to my personal situation.

hyperlexis wrote:
Well now a lot of people on the Internet who are not medical people know you live alone.....

Never said I lived alone...

Pugsy wrote:I am home alone probably 6 nights out of 7 a week.

is what I said. You are assuming that I live alone. I don't.
Actually my personal situation has been mentioned here on the forum often in the past for someone who knows me.
Where I live...only a few people on the forum know that fact and it is because I choose to tell them.
Knowing that Pugsy who lives in SW Missouri (that's a pretty big area) might be alone 6 nights a week isn't going to put me at any more risk than anything else. Pugsy isn't in the phone book.

I used to do similar home visits for insurance companies. It was many years ago and it was because the person had applied for a type of insurance policy that required such a visit. I was advised to be on the alert for a lot of things that you wouldn't expect me to be on the look out for that was potentially an invasion of privacy and to report such findings back to the insurance company without my telling the person that I was going to do that.......

Here's an extreme example of why I don't want just anyone in my home....I know it is extreme but it is not an impossibility....
Now let's say I was doing a good job while I was on my meds....let's pretend I am crazier than I am ...that I decided I no longer needed those meds to keep me from hearing voices in my head to go kill someone...now suppose I know where your dad lives because I gave him a home visit 6 months ago when I was on my meds and was "normal" and now the voices in my head are telling me to do bad things to your dad...would you really want me to know where he lives or his personal situation?

hyperlexis · Post by **hyperlexis** » Sun Sep 08, 2013 11:21 am

Pugsy wrote:
hyperlexis wrote: But the program itself isn't bad because you happen to have those personal issues.
Hey....where did I say it was a bad program? Someone ask if anyone else had got a similar notice offering such a home visit and I responded that I did get a similar notice and explained why I declined.
Please don't put words in my mouth that I didn't say...fair enough??? I never said it was bad. I get real testy when people do that.
Notice the "I" and the "my"...
I don't see "bad" anywhere in my statement about my own personal feelings about what was being offered. Do you see it anywhere below???

Pugsy wrote: I got a similar notice (and a phone call) from my Medicare Advantage carrier (not Humana) about sending someone out, but no mention as to the person being a doctor, for a home check up and discussion about meds or whatever.
I politely declined. To me that is an invasion of my privacy...I don't need or want some stranger coming to my home.
I am quite capable of managing myself with my PCP office visits.
I don't think it is something that is done to get out of paying for a doctor....it is offered maybe as a wellness thing as a policy benefit and I guess it might be useful for someone who doesn't see a doctor regularly or is maybe getting a bit senile or maybe they are just plain nosy. I don't/didn't like the idea and I don't think it is any of their business what my meds are or when I take them or anything else related to my personal situation.

hyperlexis wrote:
Well now a lot of people on the Internet who are not medical people know you live alone.....
Never said I lived alone...
Pugsy wrote:I am home alone probably 6 nights out of 7 a week.
is what I said. You are assuming that I live alone. I don't.
Actually my personal situation has been mentioned here on the forum often in the past for someone who knows me.
Where I live...only a few people on the forum know that fact and it is because I choose to tell them.
Knowing that Pugsy who lives in SW Missouri (that's a pretty big area) might be alone 6 nights a week isn't going to put me at any more risk than anything else. Pugsy isn't in the phone book.

I used to do similar home visits for insurance companies. It was many years ago and it was because the person had applied for a type of insurance policy that required such a visit. I was advised to be on the alert for a lot of things that you wouldn't expect me to be on the look out for that was potentially an invasion of privacy and to report such findings back to the insurance company without my telling the person that I was going to do that.......

Here's an extreme example of why I don't want just anyone in my home....I know it is extreme but it is not an impossibility....
Now let's say I was doing a good job while I was on my meds....let's pretend I am crazier than I am ...that I decided I no longer needed those meds to keep me from hearing voices in my head to go kill someone...now suppose I know where your dad lives because I gave him a home visit 6 months ago when I was on my meds and was "normal" and now the voices in my head are telling me to do bad things to your dad...would you really want me to know where he lives or his personal situation?

Let's just agree to disagree. There are plenty of people who know where I live, like pizza delivery men, meter readers, my crazy neighbors, and my mailman. And none have yet tried to rape or murder me.

Although I am sure I am not nearly as pretty as you.

So if the anonymous Chinese restaurant delivery boy hasn't raped me yet, I'll take a shot with a medical person from a reputable home care company that contracts with Medicare and carries lots and lots of liability insurance and has various certifications with the state.

CapnLoki · Post by **CapnLoki** » Sun Sep 08, 2013 12:03 pm

hyperlexis wrote: While you and I are pretty up on our healthcare needs, etc., do you realize how many millions of Americans, especially the elderly on Medicare, are not? It's why diabetes and high blood pressure and heart disease and all their related conditions are so prevalent. People simply mismanaging and not controlling chronic conditions is one of the biggest drivers of U.S. healthcare dollars. ...

I wouldn't disagree with your point that many elderly have issues keeping on top of their health care, but there was an interesting study released by the CDC a few days ago:
http://www.cdc.gov/mmwr/preview/mmwrhtm ... mm6235a4_w
The article discusses avoidable cardiovascular deaths, which are either preventable or treatable with proper care. Although the death rates are generally declining, they are declining much faster for the over 65 (i.e. Medicare) population.

CDC Report wrote: Age-specific differences in risk factor management also might have contributed to the slower decline in the younger age group. Compared with persons aged ≥60 years, during 2009–2010, adults aged 18–39 years with high blood pressure experienced lower rates of treatment (43.5% versus 83.6%) and control (28.6% versus 47.0%) and saw no improvements in those rates from 2001 to 2010 (15). Furthermore, among persons aged 35–44 years, stroke hospitalizations increased during 2001–2006, whereas they remained constant for those aged 45–54 years and decreased among those aged 55–64 years (16). The finding of a slower decline in avoidable deaths in younger age groups in this report highlights the importance of improving prevention, diagnosis, and treatment efforts in younger adults.

The cause is the reduced access to (and use of) preventative care by the younger population. It will be interesting to see if these numbers change in the coming years with ObamaCare.

Pugsy · Post by **Pugsy** » Sun Sep 08, 2013 12:08 pm

hyperlexis wrote:So if the anonymous Chinese restaurant delivery boy hasn't raped me yet

That's good to know.
Maybe you wouldn't be so flip about it if you had been raped in the past.

driftervii · Post by **driftervii** » Sun Sep 15, 2013 1:45 am

my doctor who i've seen for the last 12 years once a month has stopped taking medicare and hes dropped all medicare patients. im not happy. All you Obama defenders can talk and talk but you really don't know till it effects you. i've still not seen or heard from someone on medicare that thinks obamacare is good thing. my quality of care has definitely went down since Obama came to office. as a matter of fact quality of life in general has went down.

More Doctors are now taking medicare than accepting private

Re: More Doctors are now taking medicare than accepting private

Re: More Doctors are now taking medicare than accepting private

Re: More Doctors are now taking medicare than accepting private

Re: More Doctors are now taking medicare than accepting private

Re: More Doctors are now taking medicare than accepting private

Re: More Doctors are now taking medicare than accepting private

Re: More Doctors are now taking medicare than accepting private

Re: More Doctors are now taking medicare than accepting private

Re: More Doctors are now taking medicare than accepting private

Re: More Doctors are now taking medicare than accepting private

Re: More Doctors are now taking medicare than accepting private

Re: More Doctors are now taking medicare than accepting private

Re: More Doctors are now taking medicare than accepting private

Re: More Doctors are now taking medicare than accepting private

Re: More Doctors are now taking medicare than accepting private