Question

What reasons could account for the gap between the reimbursement for multidisciplinary care and the expenses of delivery of multidisciplinary care?

Answer 1

A multidisciplinary approach implies that the medical team comprises of endocrinologist, practicing nurses, dieticians, diabetes specialists and even psychologists. Using the Medicare’s resource based revenue model, there is only a single payment for the services offered by these combination of specialists.

As per data, the revenues generated were sufficient for covering the expenses incurred for the physicians. However as per the Medicare’s resource based revenue model, the revenues generated could only cover barely 16% of the real expenses incurred for non-physician related activity when considered under the multidisciplinary model.

Thus due to the presence of several non-physician activity, there is a mismatch between expenses incurred and reimbursement done.