Tuesday, April 3, 2012

Depression and the $17 Diagnosis

Depressed? Are you a senior on Medicare? Are you depressed because you are a senior, or depressed because you are on Medicare or simply depressed because you are a senior on Medicare?

This is an election year. Candidates on both sides use seniors and Medicare as a political football. Each side blames the other as the bad guy (or gal) who, if elected, will cut your Medicare benefits and appoint a death panel to make sure you don't bankrupt Medicare by expecting the taxpayers to fund all your health care bills.

It's enough to get anyone down.

Kaiser Foundation reports that, coming in October, Medicare will begin paying doctors to diagnose depression.

Paying doctors to screen for depression -- Medicare's going rate is $17.36 per person -- may well increase how often they do it, say experts.


A $17 payment will result in more diagnoses?

Seems a bit of a stretch to me.

Most primary-care practices that screen for depression use a tool called the patient health questionnaire. The PHQ-9, as it's called, asks people to describe how frequently during the past two weeks they have felt down or hopeless or taken little interest or pleasure in doing things. It also asks about sleep patterns, appetite and concentration, among other things. Although the test can be taken in just a few minutes, a 2001 study indicated it identifies depression and pinpoints its severity nearly 90 percent of the time.

The good news is, this simple test has a high success rate.

The bad news is, with Medicare low reimbursement rates, how many docs are willing to spend a few more minutes with a patient who may or may not be depressed, in exchange for $17 when there are patients in the waiting room that are more profitable.

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