Medicare payment cuts set for doctors

[deadparrot]

WASHINGTON - Medicare reimbursements to doctors are set to drop by nearly 5 percent next year, an amount that physicians say could make it harder for elderly patients to see a doctor.

Mark McClellan, administrator for the Centers for Medicare and Medicaid Services, told reporters Monday that the agency would soon issue new regulations updating reimbursement rates for physicians. He did not provide an exact amount the rates would change in 2007, but trustees for the Medicare program projected in May that the cut would be 4.7 percent.

The reimbursement rates are established by formula, which sets annual and cumulative spending targets for physician reimbursements. When spending increases exceed economic growth, payments to doctors are supposed to be cut.

McClellan attributed proposed payment reductions to a "vicious cycle" in health care. Doctors provide more and more services per patient, which drives up Medicare spending faster than the overall economy.

http://news.yahoo.com/s/ap/20060807/ap_on_go_ot/medicare_doctors

[OzarkDem]

1. Its the high cost of prescription drugs

The GOP refuses to allow Medicare to negotiate prices with Pharma companies, so it makes up the cost by cutting reimbursement rates to docs. Makes sense in GOP Land.

[Monkeyman]

3. YEP like the VA

[itzamirakul]

7. Makes sense in GOP Land until some of those good ol' boys and

their wives, who support Bush 100%, are turned away from much-needed treatment. Then, FINALLY, it will hit home and they will wake up 7 years too late.

The new Democratic President in 2008 will have to accept the blame for all of the failed Bush policies including this one and the Pharma plan.

[Acadia Blue]

15. I guess the doctors never realized they would get hit too. Most of

them support monkey boy and the monkey gang.

[TaleWgnDg]

2. Nah. I attribute the rise in costs to reality. And, the reality is . . .

.

Nah. I attribute the rise in medical costs to corporate bureaucracy and padded costs by the most expensive delivery system of healthcare on the planet = corporate American healthcare.

America stands alone w/ such an inefficient and costly healthcare delivery system. Rife w/ costs and more costs. Third-party crap. And, it is that which "drives up the costs" of healthcare in America.

These SOB Republicans who kiss corporate ass should fess up. Get real. You know, grab ahold of some "moral values" and tell the truth for a change.

May those Republicans all rot in hell for the anguish placed upon elders across America by them all.

.

[Stargazer99]

4. Just another way for the GOP

To kill off the old, sick and poor without looking like they engineered it.

[cosmicdot]

5. will the program lose doctors who currently accept Medicare?

is that one of the objectives of Scott McClellan's brother, Mark? ... an inside mission accomplished-in-process? Is he helping to slowly drown the program in the bath water by screwing things over? Is this a "you're doing a heckuva a job" thing?? It just seems that whatever they do, whatever they touch, it spells disaster; and, not in citizen's best interests ...

What of these "structural changes" he's talking about ... "Those changes would focus more on paying
doctors when they provide services proven to improve patient outcomes rather than just reimbursing doctors for more care."

What does that imply?


it's going to take a Big Broom to sweep Washington out if we have an honest election come 2008


it's just not elderly patients ... people on Social Security Disability have Medicare, too


McClellan "said he is seeing more leadership from physician groups this year ..."

What groups are they?

[Donnachaidh]

9. there are ALOT of Doctors who don't take Medicare

even before this cut. It's virtually impossible to find doctors who will take Medicare as the sole insurance. And they don't even bill Medicare if it's secondary.

[knitter4democracy]

17. If they take it, they limit their numbers.

I forget the exact numbers (they were in an issue of Medical Economics, if I remember right). If a doctor has much above one-third of his patients on Medicare alone, he won't break even. I know the practice where my hubby works keeps an eye on their numbers and that the partners are talking about a cap.

[Nimrod2005]

14. Yes, and move more people into HMOs...Another way for the GOP

to do away with Medicare...

[Sgent]

6. The formula is broke

It has been acknoledged as being broke since it was passed (in the mid 90's).

The formula works like this:

Add up all money spent for physician, labratory, outpatient, and medical services provided in 1996.

Adjust total for general inflation (CPI-U).

Split that total amongst all services provided for 2007.

Do not adjust for changes in enrollment, increasing costs that outstrip inflation, etc.

This means that the average family physician has gone from 200,000k/yr in 1980 to 120K today (in real dollars). In some places, I can hire a physician for as little as 85k base salary.

It also means that its cheaper for many doctors to opt out of Medicare than to accept it -- even if they end up writing off some charges due to being uncollectable. In underserved areas, good luck finding a specialist that accepts Medicare.

For instance, in my area 2 years ago we had a 60 y.o. who had a skin cancer (melenoma) on her cheek. Now, the nearest plastic surgeon who accepts Medicare is 350 miles away (plastic surgeon), and the cancer was diagnosed and biopsied by her family physician (no dermatologist). So this lady wound up having a general surgeon remove it from her cheek.

Things like radiologists to do breast screening, cardiologists to do outpatient medicine, surgical specialists, etc will get harder to find.

[customerserviceguy]

12. The whole thing is broke

After five and a half years without medical insurance, I finally got some at a job that I started working at last year. I didn't see any great details on my doctor's bill (had a routine physical, the first time in over half a decade) but the statement I got from the lab was most telling. The biggest "savings" to me was not what Blue Cross paid, but the reductions in cost that they negotiated, then paid most of the greatly lowered bill. I had to ask myself, who makes that up? Then I knew, it was people like me who didn't have insurance back before this job.

Medicare, Medicaid, and private insurance have third-partied the whole thing onto the backs of the people least likely to be able to afford it, the uninsured, who just have to go without when they have a medical problem. The system is way broke, and is in serious need of fixing.

[NNguyenMD]

8. NYS clinics and medical centers designated Article 28 will see anyone

regardless of their ability to pay. In return the reimbursment rate is a little bit better than if the group of physicians don't participate in the program. Most all large academic hospitals (i.e. Upstate University Hospital Syracuse, Kings County hospital Brooklyn, the major hospital affiliate of Univesity of Buffalo and Stony Brook, etc) will not deny you access however at the same time it is a notoriosuly insufferable wait to access their services.

Imagine that you're the ONLY specialist in town who works at an article 28 facility, you're likely to see way more than 20 pts on your clinic day with 15 maybe 10 minutes scheduled to see each one. I rotated through the practice of one of the only Plastic Surgeons in town and he subspecialized in a field where he works in orthopedics, because if he functioned as a plastic surgeon in our area he would be working literally ALL THE TIME.

I've also worked with a group of family physicians in a rural location in upstate NY that was article 28, and they told me that while their compensation was less, and have to see more patients on average they sleep a little better knowing that the continuity of care is preserved because they don't deny people access based on ability to pay.

I'm not thrilled with the big city uber-specialist system we have in this nation, I think that generalist in rural areas by and large bear a huge burden wearing lots of different hats to provide their patients with adequete services. Thats just to emphasize that your local rural generalist is often just as if not more capable than your superspecialist in the big city.

[Iowa]

10. Yep.... regarding your comments about local generalists:

We have several choices in our small town, and we have been very impressed with our Physician Assistant. We like the way he thinks, his knowledge base, his enthusiasm, and his creativity. He's our top choice for first contact - and he can usually handle what we need.

We also have specialists a half hour away, and we wouldn't hesitate to use them for some things - like whenever any sharp or pointed tools come into play. But even then one must know who you're dealing with. There are some real hacks out there - even specialists.

[knitter4democracy]

20. Thank you for that.

I'll make Hubby read this. He's had a hard year with his patients, and sometimes he feels like he doesn't have the support network for his patients like he needs. We're not even in a real rural area, even. *sigh*

What a broken system we have.

[w4rma]

11. Doctors don't make enough money as it is for the amount of training

they have to go through to get to where they can perform their jobs.

[knitter4democracy]

18. Some do--it depends on their specialty.

Internists like my hubby make just enough to pay back the amazing med school debt and consumer debt from residency and keep up with current needs. We're still mostly paycheck to paycheck, though.

Radiologists make over five times what my hubby makes. Many are retiring early, which is causing a shortage. Pathologists also make good money.

Pediatricians and Family Practitioners make the least, and I know some who are in trouble financially.

[Nimrod2005]

13. The beast is starving alright, it is what the GOP always wanted...

[NMMNG]

16. No problem

It's only the elderly and the disabled who will suffer. :sarcasm:

[knitter4democracy]

19. So much for AMPac's support and tons of money.

Serves them right, those idiots. We never give them any money, even though we get a mailer from them at least once a week. They only support Republicans, and this shows why they're stupid for doing so.

They never even did a story on Dr. Dean in their AMNews. I've seen two articles on Frist, though. How's that for slant?