And unfortunately I have to agree with many on here that the new model really is Kaiser....you see the national debt is around 15T now but the govt obligations over the next 20-30 yrs in 100T!...most of that is in Medicare obligations...wonder why the news says mammograms or PSA's shouldnt be done anymore?..this is sponsored by govt wants and needs... they dont want you to live to be 90 anymore cause we cant afford it as a society.
So the govt is being smart and will say in the future, you have prostate cancer, we will give you 30K to treat...you greedy specialist mofo's go at it but you wont get a dime more...well this is smart on their part cause this will cause doctors to order less tests and not more..."do I really need to order that 4K PET scan"???...can we treat with hormones alone vs radiation or surgery...the govt puts the onus on us the save money by allowing greed to work in reverse.
The govt is pushing for a single payer model whether we admit or not...the days of private practice are already over to some degree cause as you dont get patients by being a good doctor anymore...you get them cause you are in a enclosed system where they have to refer to you cause your group is the preferred provider to that health plan or you are in a huge multi-discipline group that refers to themselves only to keep the machine going.
ACO's, CCO's and etc will grow...you can label it whatever acronym you want but the bottom line is it is a HMO type model...you will make more to do less when you get paid by the diagnosis and not fee for service which promotes more tests and scans and certainly more procedures...in the future, you will need to be part of a huge organization in order to compete....the govt is giving away millions of dollars to hospitals to implement electronic medical records not out of the goodness of their heart but to data mine you in the future...medicine will be like any other govt red tape entity where inefficiency will reign supreme as you will have to document and justify every single CPT code charge you submit.