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ICD-10 Good for Providers, Too

Re: "The Why Behind the What" by Albert Oriol in H&HN Daily, Nov. 8

In regard to using ICD-10 as a means to "pay providers less," that may be the case for some payers. Life is like that: Some people will always try to milk a situation, take advantage of others or even steal from others. But I think that the specificity of ICD-10 will be widely used to pay more accurately. There can be a wide variance between the effort and
intensity of services needed to address certain indications that, prior to ICD-10, were all lumped together under a more general ICD-9 code.

Under ICD-10 (at least over time), some providers will be paid more for what they were previously paid less and some providers will be paid less for what they were previously paid more. Of course, these payment revisions will only occur for providers (typically facilities) that are reimbursed based on some consideration of diagnoses codes (DRG, case rates, etc.)

As ICD-10 and related service data are gathered over years, I think other payment mechanisms — even straight FFS rates — will be more finely tuned as better insight is gathered and proven. I think it's too early to state that only payers will benefit, because with better data, providers will be equally able to contract for what they truly should be paid.

— Steve Sisko

A Worthy Advocate

Re: The Interview with George Bo-Linn, M.D. of the Patient Care Program, October H&HN

So great to see Dr. Bo-Linn leading this important initiative. I worked with him for several years and he was and remains very passionate about the patient experience and patient safety. Dignity, respect and patient engagement are the key ingredients for a culture of healing, which is needed as we continue to evolve our health care delivery system. Thank you, Dr. Bo-Linn, for continuing this important work!

— Laurie Eberst

Med Students' True Motives

Re: "Steering Med Students into General Practice" by David Ollier Weber in H&HN Daily, Oct. 23

Well, sure, 38 percent of ENTERING medical students claim to plan on being primary care doctors. They're not dumb: they know that it improves their chances of being admitted. After all, the medical schools receive higher funding if they produce more primary care doctors. More interesting would be to know if the proportion of GRADUATING medical students still have the same plan.

— John Kulli, M.D.

Promoting Primary Care

Re: "Steering Med Students into General Practice" by David Ollier Weber in H&HN Daily, Oct. 23

Since primary care and preventive medicine have their locus of care outside the walls of teaching hospitals, and medical students are largely influenced by cultures and role models, perhaps it is time to rethink how to "steer medical students into general practice."

Alternatively, perhaps that time has come — and gone — for physicians, now that nurse practitioners — supported by medical protocols, computers, remote monitoring devices, telemedicine and virtually integrated clinics — are trained, ready, willing and able to do what the vast majority of physicians chose to abandon in the past.

— Ron Hammerle
Chairman Health Resources Ltd. Tampa, Fla.

Please, Doc, Don't Retire

Re: "His Doogie Howser Moment" by Bill Santamour in H&HN Daily, Oct. 23

I've been trying to figure out the age of my doctor. She's been a good match for me and I live in fear of when she retires. I don't have the confidence that I'll find someone as thorough, kind and understanding as she is. But as your blog shows, change could be good.

— Trish