Yes.....I've heard of it, or a similar plan. I'm wondering however how they can guarantee no long waits to be seen? I've been in the health care field long enough to know that clients don't always 'plan' when they need care and that epidemics of the crud go around cyclicly and so do seasonal related accidents and ouchies. Perhaps routine appointments could be scheduled to accomodate such an idea.

If you plan on four visits a year for each patient, that would translate to about ten patients a day if the doc wanted to work a five day week and take a modest holiday. That's planning on spending almost 45 minutes with each patient per visit. I doubt that happens, however since the doc would have to free up time for the urgent cases who need to be seen who call in without a scheduled appointment. But, most docs make hospital rounds, need to read charts before seeing their patients, and so all sorts of other things including paperwork and consults.

You know, that's an extra 90K income for the doc above re-imbursement for their fees. If that money makes up for lost patients they would have taken on, maybe necessary. The whole question is what is their average patient load? If it's waaaaaay over 600, then it may be worth the added fee. It all boils down to if they can deliver their promise. That may well depend on how many doctors you have in your area. If physician services are tight it might be a deal. If you have lotsa docs per capita and you don't have a problem getting a patient seen, it might not. It may mean little if you still go in and sit in a gown with your butt hanging out in an exam room for forty five mintutes and see the doc for five.

Personally I think physicians should cut-off their patient load at a point where they can accomodate patients in a timely manner anyway, without having to be bribed to do so. rofl.

Calliope, I looked it up on the Internet. No Thanks! The main point is prevention. If I haven't learned how to take care of myself by now, I'm not about to pay a doctor to tell me what I should do. I might feel differently if I had a problem of some sort that she needed to watch.

I am curious as to whether or not Medicare will pay. I don't see how it could pay for everything.

I'm with you....Doctors can easily restrict their patient load. Not taking any new patients would work.

I think my doctor is going to have a tough time getting enough patients to pay expenses. She has a huge elderly patient load.

I agree with you. Prevention starts with an individual's choices long before medical sequela happen. I think there is a law of diminishing returns on how much money the economy pumps into 'medical' prevention. When you hear it on C-span you'd think nobody is ever going to get ill or die if they prevent enough. Sorry it doens't work like that in real life. Even healthy people who do all the right things get cancer and abdominal aneurysms and strokes. It will certainly help curtail costs for treatment of diseases, but I really think not as much as one would be led to believe.

I suspect the lower compensations providers receive for services to the poor or elderly than if their clients were privately insured or self- pay might explain why this program. This way they can work less and earn more. Expect this trend. It will happen.

agnespuffin, I've never heard about it before your post.Glad you posted the question.

It seems that it is a good way for doctors to get into semi retirement, they reduce their patient load and get paid by "membership" fees @$1,500 a pop.
The question is, how does it work for the patients?

I don't think 600 patients is easing into retirement. That's enough of a patient load you'd probably be plenty busy. I predict it will be the face of things to come under the new health care law because cuts of payments to all health care providers for medicare patients are coming. Physicians are not required to take medicare, but face it...... if you were a gerentologist or internist whose praticise is comprised mostly of the older population they'd lose a lot of patients if you excluded the over 65s. A better answer is to continue to service these clients but ask for what amounts to a retainer for the priveledge. It essentially means those physicians or facilities will not be harmed by the reimbursement cuts. It just means the elderly will pay more out of pocket for their own care and nobody's pointing fingers at the government either, are they? They can add that to the part B, the Part D and their supplementals and deductables.

Those seniors who cannot afford to dig deeper to assure continuation with their provider of choice, well they'll have to find a provider who does not charge this retainer and still will accept medicare. Nobody really believed that the health care community was going to take a pay cut did they?

Those physicians who continue to accept medicare will not only face increasing patient loads to cover for those who drop servicing medicare patients but that also translates to decreasing compensation per visit or service, and longer waits for appointments for the patient trying to get in.

I've spent a good bit of time tonight reseaching the Internet on this.... Nope, it's not for me.

It's not just the yearly fee, it's the whole idea of the doctor restricting his/her practice to those people that think it's a dandy idea to pay a yearly fee just so you don't have to wait a long time to see the doctor. I don't think I care for that type of MD.

I would still see my allergist, my dermatologist, the orthopedist and the gastroenterologist. (did I spell that right?) I don't have headaches, upset tummy, colds, or any of the usual minor things. 1500 bucks to have my BP and weight checked twice a years, just seems a bit much. I think I'll get my #3 son to do that. He can check it when he comes to lunch every Friday. I think I should get something for helping him get through Medical School.

I'm betting that unless she is desperate for patients, she will soon manage to drop Medicare. It just pays too little for the time spent. The entire concept of the MDVIP style is to spend a lot of time with the patient, giving advice on how to live longer,and better, and healthier. If I don't know how by now, I'll never learn!

When you think about the cost of maintaining a practice, salaries, malpratice insurance, rent, new supplies, etc. maybe the 1500 per year fee would go fast.

I called to cancel my next appointment today. I wasn't asked if I wanted to schedule it later. I must not have been the only one, as the phone was busy, busy, busy for hours!

You really can't blame physicians for being proactive. Of course they have high overhead. The plan as I understand it is to reduce reimbursement for medicare, and at the same time increase reimbursement for medicaide. There are going to be all sorts of adjustments in the short run. It's going to be difficult, however, to bring any kind of equity to the table for those seniors who cannot afford a surcharge in addition to their current medical expenditures. I am not on medicare yet, but I have figured out what it's going to cost me annually when I do reach 65 and frankly I'll be spending almost as much for coverage as I presently pay for my health insurance in a private policy. To add another grand to it, I'll be paying as much for an "entitlement" as I pay now.

Thanks again for posting the subject. I have looked into some things on the web, and I don't think it's for me (us) at this time.
For one thing, our insurance company has given us a "free" membership to several health clubs in our area. No need to pay a third party.

" if you were a gerentologist or internist whose praticise is comprised mostly of the older population they'd lose a lot of patients".
Our doctor specilizes in geriatric patients, (lol, that's us). He knows that the baby boomers are aging and that he will have patients for years to come. No need to worry.

Our doctor specilizes in geriatric patients, (lol, that's us). He knows that the baby boomers are aging and that he will have patients for years to come. No need to worry.
That's why you should be worried. Those docs whose practise revolve around the aging population would have the most incentive to charge out of pocket fees to be seen because they will have a huge client pool and can afford to be more choosy about who they keep as patients...... and would face the greatest loss of income by reimbursement cuts.

That's going to translate into longer waits to be seen, and busier offices and larger caseloads for those who will continue to accept medicare payements.

Oh well, if our doc decides to change his ways and if we don't like it, we are fortunate enough to have plenty of choices in our area.

I think grade schools and high schools ought to be teaching basic med. I think drugstores ought to deliver some prescriptions by the numbers - sugar, cholesterol, bp -
I think most prenatal care, and most normal deliveries could be midwives rather than Drs. I think LOTS of nutrition and preventives could eliminate the need for Drs. except for when the need is critical - based on knowledge gained from grade school and high school med classes.

A Dr. is no more responsible for a life than a policeman, a school teacher, a crossing guard, a bus driver, a traffic cop - not sure they need to earn so much, or pay so much in malpractice insurance.