Physician Patient

Welcome

Minnesota Physician-Patient Alliance, Inc. ("MPPA") is a not-for-profit organization committed to improving our health care system. We do this by communicating information to the public and within the industry about important health care issues.

MPPA believes that efficient, quality health care depends on strong doctor-patient relationships. Interference in the doctor-patient relationship by third parties such as health plans and the government, is widespread in today's health care system and often limits what doctors or patients are allowed to do, altering market-based reimbursement, and undermining the traditional ethics of the medical professions. While the intentions of the third parties in interfering with the relationship may be honorable (for example, to control costs or improve quality), ironically the cumulative effect of this interference is unnecessarily high costs and reduced quality. Efforts to reform health care, therefore, must first and foremost address the issue of strong doctor-patient relationships.

The MPPA board consists of physicians, health care consumers, and others who share these concerns and values. We seek to communicate our message by collaborating on research and publication, sharing information about market developments, and individually being active in a variety of health care and community organizations.

To see who belongs to MPPA, please visit our Who We Are page by clicking on the link to the right. To see some of our communications, click on one of the Publications links to the right. If you would like to learn more about MPPA or our positions, click on the Contact Us link to the right.

MPPA was established in 1997 as a Minnesota 501(c)3 charitable nonprofit organization. If you would like to be added to the MPPA listserv, the respected MPPA online discussion group, send us your contact information and we will add you.

Jul 10

Motivational Interviewing

iconJuly 10th, 2018

http://www.medicaleconomics.com/med-ec-blog/doctors-and-patients-can-benefit-motivational-psychology?elq_cid=486445&elq_mid=2215&rememberme=1

This well written article by Rebekah Bernard MD highlights a perplexing dilemma for physicians and patients today. Doctors and other professionals who are denoted as “providers” within a clinic, insurance plan, or government program are graded and paid based on lab tests or questionnaires aggregated as scores for their performance derived from a population of patients who’ve been (arbitrarily) paired with that physician or “provider.”

Yet, we know that in most outpatient settings physicians have little control over what their patients will actually do. The terms “patient adherence” or “patient compliance” attempt to quantify discrepancies between the recommendations of the physician and the actual result of the patient in following his or her advice. Ironically, given the narrow (and narrowing) time crunch for allowable doctor-patient interactions, current P4P methodologies are likely to discourage patients from taking responsibility for their health care.

That’s where motivational interviewing comes in. Motivational interviewing https://en.wikipedia.org/wiki/Motivational_interviewing enhances (realistic) patient and doctor decision-making. It helps put “skin in the game” for patients and doctors, especially when both patient and doctor can readily compare real, consequential prices of health care services, medications, and insurance benefits.

Jun 24

Re: http://www.startribune.com/big-medicare-shift-coming-to-minnesota/486297431/

The advice to “Stay calm, and check your mail” from Minnesota Council of Health plans CEO Jim Showalter is not at all reassuring. Be skeptical when government or Big Business says not to worry about Minnesota Medicare costs or choices.

For about 400,000 Minnesota patients (consumers), the Medicare Cost Plan option is going away next year. 
Compared to other states, Minnesota has a lot of patients now enrolled in Medicare Cost plans. But it’s also true that Minnesota has a growing majority of seniors who are enrolled in Medicare Advantage plans (at least 53% https://www.medicareresources.org/minnesota/ ) compared to thoise on traditional fee-for-service Medicare.

The difference between a Medicare Cost Plus and Medicare Advantage plan is that a Cost Plus patient is able to go to a “health care provider” of her choice outside of a restricted provider network. https://health.usnews.com/health-care/health-insurance/articles/medicare-advantage-vs-medicare-cost-plans-whats-the-difference
 
Minnesota seniors will receive a huge increase in solicitations for Medicare Advantage plans. But will this result in true competition for access to quality care? I’m very skeptical. The business frenzy is due to the now dominating managed care business model in Minnesota. Whether sponsored by government, businesses or insurance companies, the managed care companies make money (profit) by ensuring the difference between the aggregate payments they take in for a population of patents and what they pay out to the care “providers” who actually treat the patients. To succeed financially, organizations (whether profit or nonprofit) must tightly control their payouts to their “provider” network (hospitals, physicians, and other health care professionals). Today, payers pass on the financial “risk” of the 10% or so most expensive patients to their “providers” through Accountable Care Organizations (ACO). Then the contracted “providers” internally restrict access to expensive and “unnecessary” health care. https://innovation.cms.gov/initiatives/Next-Generation-ACO-Model/
 
The Minnesota Medicare crunch is here.