Federal and state agencies and insurers are studying an increase in fees paid to doctors, who receive an average of $60 per patient visit. However, with the additional medical load caused by telephone and email consultations, physicians are lacking sufficient time to spend per patient.
An experiment in metropolitan Philadelphia pays per 5-member group of 100 doctors an extra $200,000 to $300,000 annually each group to take in phoned and email queries to better keep track of their 8,400 patients. Half a dozen states have replicated the experiment involving 2 million patients.
Doctors use additional payments to hire staff to help keep up with patient treatment and follow up.
Medicaid and Medicare are also studying the idea. Medicaid tried it on a pilot basis in North Carolina, which saved the state $162 million in 2006, an 11 percent savings from the old system of reimbursement used before.
Primary-care physicians in the U.S. have been decreasing in large numbers over the past few years. According to the American Medical Association, in 2006 there were just over 251,000 practicing family doctors, general practitioners and internists versus almost 472,000 specialists.
Meanwhile, for home health care workers specially those who have rural patients, New York, California and other states have started to give them prepaid gas cards, car rentals and other benefits to keep them financially afloat to take care of 12 million elderly and disabled Americans.
A study by the National Association for Home Care and Hospice estimated these health care providers travel up to 5 billion miles a year to reach their patients.
Hardest hit by the soaring gas prices are nurses, aides and other home health care staff who usually shoulder their travel expenses and depend on government reimbursements that have not been adjusted to reflect the high cost of vehicle fuel.
As a result, half of health care workers polled by the National Association of Area Agencies on Aging said they reduced home visits, while 90 percent they will make more cuts next year.
