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Medicare’s innovation chief, Adam Boehler, wants to “blow up” America’s system of paying for primary care by revamping one of its most fundamental building blocks: the old-fashioned office visit.

In coming weeks, Boehler’s office is expected to introduce a new model of paying primary care physicians that may strongly encourage them to use more modern methods, such as telehealth and online consultations, to care for patients in their homes and keep them out of hospitals.


“What you ultimately want is quite simple,” he said this month during a panel discussion at the Healthcare Information and Management Systems Society (HIMSS) in Orlando, Fla. “You want the physician to pick up the phone and not send it to the voice mail that says ‘call 911.’ You want a physician to respond to the email over the weekend from the sick patient on what to do. You want them to be paid for doing the right thing.”

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  • This is one more gimmick, to give the fale impresson that they are doing something. Telehealth migh e effective in certian situations, like check ins of established patients, in rural areas with no accsess to healthcare. The tactic they are using here is called Gas Lighting, becuse th ebig healthcare corporation have already figured out how to scam Medicare, for billions. Of course no one is allowed to investigate how a ten minute or less doctors visit, with most of the time spent entering information a tablet, is working for patients or Medicare. Our paid off policy makers and industry insiders told congress that collecting meaningfull data is “government overreach” so certian data is not allowed to be collected. Any time we ask how our healthcare sytem got so corrupt, we have to acknowldege how the industry made billions, and our corporate media failed to cover the story. The rate of suicides, drug overdoses, pharmaceutical interactions, early deaths and the despinr of Americans, should have led to questions, instad we got propaganda, lies and deceptve marketing. The average American, who pays for Medicare, has no idea how the industries have exploited the system, while the media normalized even the deaths. The industries have been extracting a massive amount of money, while heealth outcomes get even worse. Teh average low income senior, with Medicare, entitles the system to 500K to a million dollars. the system is set up to extract every last cent, while providing the worst healthcare imaginable. There is a perverse reverse incentive. It is more profitable to avoid diagnosing Cancer, or advanced Dementia, while passing the patients around. There is no sytem at CMS to recognize any of this extraction, and snce these are tax payer dollars the public is unaware, often when they are engaged with the system. CMS looked the other way when nursing homes becasme brutal, and when serious conditiosn went undicagnosed for years, even when thousands of dollars were paid out.

    All fo these gimmicks were designed to mislead us while the industry continues to bleed us dry. Rememeber there is so much profit involved they can afford the cleverest most politically connected con artists, to mislead the public and spin clever PR. The media has not covered any of this. Even when a medication mistake leads to a 50 thousand dollar helicopter ride, and even though the patients paid for insurance all of their lives, Medicare picks up the tab. They have to be selctive about the data collected, or else the public would know the truth.

  • Few pimary care physician even take Medicare anymore, leading to more Er Visits and more progress in diseases. Even the non profit providors claim that Medicare does not pay enough. In order to make money thye require multple visits for one issue, and those needing a referral are forced to return time and again. In order to maximize profits, CMS was not allowed to research any of the more costly issues, but the providors figured out how to rip off Medicare recipients years ago.

  • what I am grateful for is never having to visit an everything-for-the-almighty profit american health care provider. The day my stroke-ravaged body can’t walk four or six miles, I’ll give up and let my partner feed my remains to the heron.

  • “Financial accountability” for providers is a terrible, terrible idea.

    The whole reason for having insurance pools is to spread the risk across a wide population. Reducing the size of those pools to the size of a patient panel makes a provider far too subject to chance whether that’s just bad luck in the patient panel of a family practice doctor or whether it’s a mass shooting or climate disaster in the catchment area of a hospital. Bad bad bad plan.

    It’s one of the soundest things about “Medicare for All” is that it spreads risk across the widest possible swath making for a very robust system. Pushing risk onto providers makes for a fragile, volatile, and unfair system.

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