Clearly, this administration aims to tackle all issues at once. A noble, but daunting task. The proposed changes in reimbursement are not surprising nor necessarily unexpected. In fact, CMS has been adjusting payment rates to gradually minimize the differences between physicians for similar services (similar codes is the more correct term) for some time. However, the basic problem of physician reimbursement remains. In essences what CMS is doing is merely redistributing the pie, without offering any real or significant increases in physician payments overall. Currently, there exists a growing shortage of specialists in the United States. Static medical school enrollment quotas over the past 30 years, incentive programs for primary care training, and early retirment have left the US specialist work force spread thin, older and with fewer numbers and much larger per captia patient bases. As Congress and CMS work to adjust payments, they must look elsewhere, not to front line providers such as physicians and hospitals for cuts in spending. This includes health insurers, first and foremost, as well as pharmaceutical and medical device companies. While the AMA praises this, it is merely robbing Peter to pay Paul. While CMS’s budget for physician payments has risen, CMS acutal payments under the Medicare system to individual physicians, when adjusted for inflation, are actually no higher than in the early 1990’s. This trend cannot continue forever. Last time I checked, patients go to the doctor; are treated by doctors; have surgery performed by surgeons/doctors. Hospitals, drug companies, device makers and certainly insurance companies DO NOT provide direct care for patients, though there efforts to aid in improvments in patient care overall. CMS would do well to keep this in mind . . . jomaxx
CMS proposes Medicare payment reforms for physicians, hospitals
The Obama administration said it plans to cut Medicare payments for imaging services and specialists, and will use the savings to increase payments to physicians providing primary care. The proposal would put specialists’ payments for evaluating and managing illnesses on par with those of primary-care physicians starting in January. The move, combined with other changes, would boost payments to internists, family physicians, general practitioners and geriatric specialists by 6-8% next year according to the Centers for Medicare and Medicaid Services (CMS).
One additional step proposed by CMS is removing physician-administered drugs from the definition of doctors’ services in order to reduce the number of years in which doctors will be slated for fee cuts. The American Medical Association has called for removal for physician-administered drugs from the formula since 2002 and praised CMS’ announcement.
AMA President J. James Rohack said, President Obama, HHS Secretary Sebelius and White House Health Reform Director DeParle clearly understand that fixing the Medicare payment formula once and for all is fundamental to comprehensive health reform.
Republicans are likely to attack the regulatory proposal as a budget gimmick that does nothing to actually lessen the cost of overhauling the Medicare physician payment formula. The move to remove drugs from the spending target lessens the legislative cost of an overhaul by an amount that simply is shifted to the federal deficit.
Medicare Plans to Cut Specialists’ Payments – http://online.wsj.com/article/SB124646885862181139.html
Medicare Proposes Doctor Fee Increases for 2010 – http://www.bloomberg.com/apps/news?pid=newsarchive&sid=aGmpS7.U19m8
CMS Proposes Partial Medicare Pay Fix – http://www.nationaljournal.com/congressdaily/hbp_20090701_7444.php
Administration trims health reform price tag – http://thehill.com/leading-the-news/administration-trims-health-reform-price-tag-2009-07-01.html
www.condron.us
www.blogburst.com
www.bloglines.com