Orthopedists under attack by state and federal laws

LAHAINA, Hawaii — Orthopedic surgeons are under attack by state and federal lawmakers in an effort to control the rising costs of providing care. Many of these measures will have a detrimental effect on the forces that foster growth and quality care, according to a health care consultant.

Robert J. Cimasi

"Since the 1990s, while most professions saw an increase in their compensation, physician compensation has been essentially stagnant," said Robert J. Cimasi, of St. Louis.

To illustrate the problem, he noted the yearly threats by the Centers for Medicare and Medicaid Services (CMS) to reduce physician reimbursement for Medicare.

"Most orthopedic providers that we work for are running harder and harder, almost like on a treadmill, just to keep up," Cimasi said at Orthopedics Today Hawaii 2008, held here. He is president of Health Capital Consultants.

And for the future CMS reimbursement, he said, "there is no good news on the horizon in the next 3 to 5 years in terms of reimbursement for physicians. The professional fee component is clearly not the way to go."

Cimasi said that health care costs are rising faster than inflation and that pressures to reduce costs are expected to result in a sea change for health care delivery. This will include a shift from defined benefits to defined contributions, and an acceleration in expected demand for health services as a result of an aging population.

"The attack on the orthopedic specialty and niche providers now threatens to stifle any of the benefits of competition, halt innovation and divert attention away from the legitimate concerns related to hospital access and cost," Cimasi said.

For more information:

Cimasi RJ. The attack on orthopedic providers at a federal and state level. Presented at Orthopedics Today Hawaii 2008. Jan. 13-16, 2008. Lahaina, Maui, Hawaii.