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Related Experiment Videos

Physicians may opt out, not MCOs

P L Grimaldi

    Nursing Management
    |November 10, 1998
    PubMed
    Summary
    This summary is machine-generated.

    Physicians can now privately contract with Medicare beneficiaries, offering more choices but requiring a two-year withdrawal from Medicare. Lowering associated costs is key for private contracting to gain popularity.

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    Area of Science:

    • Healthcare Policy
    • Medical Economics

    Background:

    • Medicare beneficiaries have limited options when physicians opt out of traditional Medicare payments.
    • Physicians face limitations in charging rates that reflect market value under standard Medicare rules.

    Purpose of the Study:

    • To analyze the implications of private contracting between physicians and Medicare beneficiaries.
    • To assess the potential impact of private contracting on healthcare choices and provider revenue.

    Main Methods:

    • Review of current Medicare regulations regarding private contracting.
    • Analysis of the financial and logistical consequences for physicians engaging in private contracts.

    Main Results:

    • Private contracting allows physicians to charge above Medicare rates for covered services.

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  • Physicians must forgo Medicare participation for two years when entering private contracts.
  • Increased treatment choices for beneficiaries are a potential outcome.

    • Conclusions:

    • Private contracting offers greater flexibility for both physicians and Medicare beneficiaries.
    • The mandatory two-year withdrawal from Medicare presents a significant barrier to widespread adoption.
    • Legislative changes to reduce the cost or duration of this withdrawal are necessary for private contracting to become a more prevalent model.