Brian's calculation is why a retirement community/mostly Medicare patients, is a money losing proposition for most physicians, see some of my other financial medical posts. Throughout the USA, there is a mixture of private pay, employed people and families, as the larger portion of a hospitals' patients and reimbursements, and to become profitable, there is a limit of the size of the Medicare visits which one can take in before becoming unprofitable.
However, CMS understands this, and therefore there are CMS improvement targets to care results which provide a one time annual "bonus" from CMS, which can make or break the physician's profitability in a year. CoachK is heavily involved in that process at a major medical center in MA. There are improvement targets set at the beginning of each year. Medicare for hospitals has 2 penalty programs which affects the medicare reimbursement rates in future years, and one improvement programs. There are requirements for qualifying, etc. . . One of CoachK's former supervisors went to CMS at a high level to help improve Medicare outtcomes, however, it's also very complicated, and not easily explained as each hospital is different. .
So, just start with the assumption that a PCP with medicare only patients will have a difficulty/impossible being profitable, which means staying in business, with all the EMR and reporting requirements, as a stand alone office. This scenario is also why there is consolidation in the healthcare hospital industry, where small, rural category hospitals have merged with medical centers for reducing overhead expenses for increased profitability. The biggest expense being Electronic Medical Records. I went to a local stand alone physicians' office with my mom, and they actually were resource incompetent when asked about retrieving records from the mandated state immunization database. they declared they knew nothing about it, yet its a state required for all residents from medical offices
gotta run
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