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Medicare pay-change plan reduces paperwork. What could go wrong?

Paperwork. Is there anyone who relishes it? We doubt it. But most would agree that it is an unavoidable facet of government. Documentation is considered a rule by law mainstay because creating a paper trail enhances accountability, and at the same time, self-protection for decision makers.

Still, a goal to reduce paperwork is laudable, and one new proposal for doing so comes from the Centers for Medicare and Medicaid Services.

Why some are skeptical

The plan, which would take effect starting in 2019 if approved, calls for cutting the number of forms doctors fill out for different types of Medicare office visits from five to one. It also would reduce five different reimbursement levels to one. Not everyone is ecstatic about that idea.

CMS officials emphasize the rule change will improve care by allowing doctors to spend less time on paperwork and more time with patients. They estimate that going to a single form will save every doctor about 51 hours of clinic time per year. They also note that the one standard rate for office visits would be set at a level that won't reduce how much Medicare pays now for visits, estimated at about $70 billion annually. It will only redistribute where the money goes.

Redistribution concerns

Many medical professionals say they welcome the thought of less paperwork, but they raise concerns that the payment restructuring could wind up hurting patients. They observe that the one-fee structure means doctors would receive one flat fee regardless of whether they treat a Medicare patient in a 15-minute visit for a head cold, or an hour-long office visit to deal with stage 4 cancer.

They say that in the face of that disparity, they fear that more doctors - especially specialists - will stop seeing Medicare patients altogether. That will mean that patients who do need to see specialists will likely face longer wait-times for essential care.

Obviously, these kinds of changes represent a matter of concern for anyone at or nearing Medicare age.

This change is only a proposal at this point. It is published in the Federal Register and public comment is being accepted online at the federal regulations.gov website until Sept. 10.

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