I’ve had DM’s from people asking what cuts @shandro is STILL barging ahead with on April 1 despite a pandemic. This thread attempts to summarize ALL the remaining cuts @GoAHealth is threatening for docs. Some remain huge ??’s, thus why income for clinics in 12 days is UNKNOWN. 👇
1) Complex modifiers - the #10minutemedicine problem. Docs want to spend TIME providing thorough and quality care to pts, and the 15-24 min modifier @shandro targeted is a sweet spot btwn access & comprehensiveness. On HOLD for now as limp attempt to assuage +*public/doc protests
2) Comprehensive care plans - another MASSIVE hit to family physicians providing continuity of care to Complex patients. These plans allowed time for education, proactive mngmt and setting shared goals of care. GONE as of Apr 1
3) Driver’s medicals - @shandro and @jkenney are De-insuring Senior’s Drivers Medicals. Dept of Transport has deferred driver’s license renewals for COVID19 but @GoAHealth is plowing ahead with sticking seniors, many of whom NEED to drive to avoid social isolation, with the bill
4) De-insuring X-rays/imaging ordered by PT, chiro, audiology, etc. Particularly ironic as @shandro endorses Telus’ faceless online physicians seeing pts and being able to order whatever imaging, despite no quality/regulatory insurance. Access to diagnostic imaging worsens...
5) Cuts to radiology - de-insuring multiple radiology exams often practically done in combination with other imaging. Recently compounded by @AHS_media e-mailing AHS radiologists on Mar 13 with 1 yr notice before they were fired & radiology contracted out to the lowest bidder.
6) Daily visit capping - has confused many incldg apparently @shandro and @tarajago. BC caps 4 visit codes at 65 per day... @GoAHealth is capping >210 services (not just Visits) at 50 per day. 24/7 access is a mantra gov’t likes to spout for elections: completely contrary to that
7) Haphazardly splitting overhead from some codes - causes mass confusion esp for rural docs who may have to STOP hospital coverage if clinics can’t meet expenses while they cross-cover. Many hosp docs pay varying amts of overhead... extremely complicated & will cause HUGE issues
8) Another big unknown - @AHS_media is cutting SOME stipends physicians had been paid to compensate for unique services not covered typically by fee-for-service codes. AHS recently reversed this for some docs... but it remains unclear which docs will receive them & who won’t
9) Changing submission timelines for billings - as if the health system was not chaotic enough right now for docs, @GoAHealth staff are cutting the allowed time for billing submissions to 1/3 of what it is now. Much less than any other province allows.
10) Lowering fees pay for non-invasive diagnostic tests in hospitals (ECG’s, etc) - also has never been clarified what this means or what the new rates would be... meaning yet another huge unknown in terms of income (vs expenses) with an implementation date of Apr 1.
11) Ending “Good Faith” claims - esp nasty given COVID19 chaos... @GoAHealth will no longer cover patients who cannot “prove” AB residency/insurance coverage. Physicians will very likely still see as no patient will be left uncared for... but AB Health will not pay for that care.
12) Ending Continuing Medical Education support - maintaining learning and required education credits is expensive and this fund slightly offset a portion of what docs do yearly. Ending with <2 months notice or ability to use educational support grant funding...
13) Slashing Medical Liability coverage support - yet again, an unknown amt but specialties with high coverage rates will be crippled... Many docs will need to STOP providing those services (obstetrics/ER/surg). Esp bad for rural where that is only a small part of their practice.
14) Ending Business Cost Program (BCP) - it costs a LOT to run a clinic; BCP was $2-3 on top of a billing code to help offset that overhead so docs COULD run community clinics rather than have to move their practices to AHS facilities. Clinics will be cut by 8-10% with this alone
15) Unspecified changes to Rural/Remote support program - rural communities are already struggling to recruit and retain physicians. Cutting this program will reduce the ability of docs to stay in rural areas and will worsen access for rural pts to reasonably close health care.
16) The BIG hammer: Bill 21 allowed gov’t to unilaterally TEAR up the AMA contract. Under Bill 21, ALL contract negotiations in AB are worthless as Cabinet can end anytime. Also lets gov’t force new physicians to practice where gov’t chooses, not where that doc may feel able to.
THIS is why AB docs came into COVID19 already demoralized & defeated... as @shandro has repeatedly undercut & impugned us. And now: promoting an episodic corporate online product while paying AB docs <1/2 other provinces for telephone calls necessitated by COVID... #shandromustgo
