PracticeLink Magazine

Winter 2018

The career development quarterly for physicians of all specialties, PracticeLink Magazine provides readers with feature articles, compensation stats, helpful job search tips—as well as recruitment ads from organizations across the U.S.

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28 W INTER 2018 PracticeLink.com ▼ T HE Qua L I T Y of L I f E ISS u E D E P A R T M E N T S Reform Recap J eff at K i NS o N Growth in Medicare — and in proposals to change how it is funded Congress is weighing proposals that include converting Medicare to a voucher system. M e D i C a R e i S a PR o GR a M u ND e RG oi NG S i GN ifi C a N t GR o W t H, a ND t H e R e a R e S e V e R al PR o P o S al S o N t H e ta B le t H at C oul D CH a NG e it . Two types of plans Medicare delivers care through two main programs: Original Medicare (Part A and Part B) and the Medicare Advantage Plan (Part C). The original plan is fee-for-service with patients free to choose their physicians and hospitals (assuming the providers accept Medicare). Under Medicare Advantage (M A), patients sign up with a private company approved by Medicare, and the plan is responsible for delivering care. Medicare Advantage plans generally are h M o s or PP o s where the patient's choice of providers is more limited. A patient will pay a higher share (or potentially all) of the costs for out-of-network care. Medicare Advantage plans receive a fixed amount each month per enrollee from the federal government. Medicare Advantage plans usually offer benefits to patients that are not available under original Medicare, such as coverage of vision and dental care. Enrollment in Medicare Advantage plans has increased more than 70 percent since 2010 to about 19 million, according to the Kaiser Family Foundation. Private contracting with patients Among the proposals to change Medicare is to allow physicians who participate in Medicare to enter into contracts with patients to pay more than the Medicare rates. Under current law, physicians who participate in Medicare agree to accept the Medicare fee schedule and not balance-bill the patient for anything beyond the 20 percent copay that is paid by the patient or the patient's supplemental insurance. Physicians who opt out of Medicare are free to charge whatever they wish. Psychiatrists make up the largest portion of the opt-out group. Under current law, a

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