This article is more than 5 years old. Information may no longer be current.
A time for personal decisions: More Medicare cuts are scheduled for 2008
Click Here to Manage Email Alerts
“Congress blocks 5% physician payment cut for 2007” – that is the headline for one of the top 10 news stories of 2006 chosen by our Editorial Board from those reported in Orthopedics Today. It was big news to physicians and patients, because the decision basically held the reimbursement to 2006 levels.
Many of our national medical organizations (for instance, the American Academy of Orthopaedic Surgeons) helped to lobby to block the scheduled cuts. Because it applies for only 2007 this is only a transient victory, unless a similar effort succeeds this year. Orthopedic surgeons may see proposed cuts approaching 10% or more in surgical fee reimbursements for 2008. The net losses may be even larger given further increases scheduled for evaluation and management services.
|
|
Making a dent
In 2006, patients and physicians made Congress understand that if the cuts scheduled for 2007 won approval, more physicians would restrict Medicare access.
As a result of the 1-year delay, my partners in our orthopedic surgical group did not have our yearly discussion on how to deal with increasing Medicare cuts. For the past 4 years, we have considered opting out of Medicare, but so far we have decided to continue with the program. We listened repeatedly to the reasons for continuing with Medicare and reviewed the our colleagues’ experiences who either have already opted out of Medicare or have limited the access and number of Medicare patients in their practice. Each year it has been difficult to obtain a unanimous vote from my partners but we have stayed as a group within the program.
We all enjoy caring for the 65 years-and-older population. I personally find this group extremely satisfying as patients and feel it is a privilege to care for them. They are some of the most grateful and appreciative patients. They have usually come to terms with life and have realistic expectations. Orthopedic surgeons have much to offer Medicare patients for “prolonging quality years” of life. Opting out of Medicare would mean that I would not be able to see many of the patients I like to treat.
Opting out
However, as an individual physician, I personally will opt out of Medicare as a participating physician if the scheduled 2008 cuts occur. I have made my decision: If the reimbursement for orthopedic surgical service is reduced by 10% in 2008, that will be the line in the sand for me. I have not minded working for less, but with overhead expenses increasing and the reimbursement decreasing, I am no longer able to maintain the quality staff necessary to give the care I feel is needed to this population.
|
Our group will be forced to make some tough decisions. We have partners that range in age from just starting to those approaching retirement. If we do not all agree to stay in or opt out, it will significantly change how our group functions and, potentially, its structure.
We know some of you who opted out have worked through this. It is going to take a while to see what lies in store for us for 2008, but the most recent bill only delays the inevitable.
Meaningful Medicare reform is coming and has been needed for years. Cuts in reimbursement and price controls as a temporary solution have reached my tolerance level and eventually, I feel, will not be tolerated by most physicians.
Unfortunately, it appears the time is coming for some tough personal decisions regarding Medicare’s future price cuts and price controls. For more information on the specifics on opting out of Medicare, please see the article on page 20.
Douglas W. Jackson, MD
Chief Medical Editor