Let the Medicare Cut Countdown Begin

November 2, 2010

That ticking sound you hear is the giant clock in Washington, D.C., counting down to December 1 when physicians nationwide face a double-digit cut to their Medicare reimbursement. Oh, and that loud sighing you hear….that's from physicians nationwide.

That ticking sound you hear is the giant clock in Washington, D.C., counting down to December 1 when physicians nationwide face a double-digit cut to their Medicare reimbursement. Oh, and that loud sighing you hear….that's from physicians nationwide.

We are now less than a month away from a proposed 23.6 percent cut in Medicare reimbursements thanks to the much maligned, yet very much alive, sustainable growth rate (SGR) formula. If you really want to look ahead, we are less than two months away from an additional 6.5 percent cut scheduled to take effect as soon as we ring in 2011.

The president of the American Medical Association, Cecil B. Wilson, told Kaiser Health News that if doctors see a 30 percent cut without any action by Congress as of Jan. 1, 2011, "this will be a catastrophe." The AMA is seeking a 13-month moratorium on any Medicare cuts to work with Congress to overhaul the entire payment formula.

Noting that the proposed cut comes during what will be a lame-duck session of Congress, Wilson told KHN that the 13-month delay gives the AMA a chance to work with the new Congress "to develop a means of getting rid of the formula, putting in a formula or a payment mechanism that recognizes increased costs of care."

Other medical groups are also pushing for change, but preparing for what could face both doctors and their patients.

At the MGMA annual conference in New Orleans, the group's president William F. Jessee, discussed the results of a member survey taken in August, looking at how practices responded to the June cut and anticipated responses to what might come in December.

Regarding the June cut, 37.3 percent of MGMA member practices delayed purchasing an HER; 31.7 percent cut the number of administrative staff; 29.5 percent cut the number of appointments for new Medicare patients; and 27.5 percent cut the number of their clinical staff.

In anticipation of the next round of cuts, 49.5 percent said they would stop seeing new Medicare patients - a statistic Jessee said "we are starting to take personally" - and 27.5 percent said they will cease treating all of their Medicare patients. The majority - 76.6 percent - said they would delay the purchase of new clinical equipment and/or facilities.

"Christmas and New Year's will be a fascinating time," said Jessee.

Today, all the political wrangling for seats in Congress ends. Tomorrow, the medical community turns up its campaign, calling upon those either new or returning to the House and Senate to do something to help both doctors and their patients.

After criticism of Congress by many medical groups in June to delay action for six-months, essentially "kicking the can down the road," they claimed, maybe one more swift boot is what's needed to focus on a real solution to the formula once and for all.

The clock is ticking doctors. Can you stop it in time? Can you buy a few more hours?

Election Day may end at midnight tonight, but your campaign is just beginning.