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Take a Role in Healthcare Reform


Because all medical practices are impacted by Medicare cuts ―as most payers tie their fee schedules to Medicare ― it is incumbent upon each of us to step up and make our voice heard.

Physicians are facing a 29.5 percent Medicare reimbursement cut come January 1, 2012. Think that's scary? Look at what a 29.5 percent cut to your top line (income) does to your bottom line: 


Summary Profit & Loss

2011 Medicare Rate
2012 Medicare Rate
% Change
-29.6 %
0 %
Net Income
-73.8 %

Ceteris paribus, the Medicare cut could reduce net income 73.8 percent. Why? Because reimbursement cuts have a disproportionate impact on the bottom line unless expenses can be cut proportionately. A 5 percent fee cut reduces net income by 12.5 percent; 10 percent from the top reduces the bottom line by 25 percent. The math is foreboding.

All medical practices are impacted by Medicare cuts, as most payers tie their fee schedules to Medicare. It is incumbent upon each of us to step up and make our voice heard. Cuts to reimbursement will reduce your net income and /or the quality of patient care your practice can provide.

Here are 10 ways you and your practice can - and should - make a difference.

1. Voter registration - Provide voter registration forms to every employee. Put them in your waiting room for patients. Legislators know unregistered voters do not affect their electability.

2. Take a head count - Count the number of potential votes your practice represents. It may be surprising. Between your providers, employees, and their families, your practice represents a significant number of constituents.

3. Engage your staff - Share the grim facts. A Medicare cut could mean pay freezes, pay reductions, or even layoffs. Ask them and their families to register to vote and make their voices heard as part of your concerted effort. On Election Day, make sure each employee has time to vote.

4. Engage your patients - Your patients' care is at stake. While you and your practice would never compromise patient care, it is very hard to provide the same level of care or spend the same amount of time with each patient when the bottom line sinks. Ask for their help in contacting legislators. Many specialty societies have materials that can assist in this effort.

5. Vote - Yes, vote. Studies show that medical professionals are much less likely to be registered voters or vote than any other professional class. Politicians know this well. Let's change their mindset in the next few years.

6. Educate your legislators - Get to know your legislators. One effective tactic is to invite your legislators to spend a few hours at your office. Most do not understand all that goes into seeing a patient and getting paid. Even if your legislator sends an aide instead, it remains a worthwhile endeavor; having the support of these aides is critical. Become a resource.

7. Contact your legislators - Send e-mails and letters and make calls to your legislators. Whenever your professional society asks that you contact your legislator, do so. Ask your staff to do so as well.

8. Wear all the hats that fit - You are more than just a doctor. You also wear the hat of primary advocate for your patients and the hat of small business owner responsible for the livelihood of employees and their families. Make sure your legislators understand your responsibilities extend far beyond your own family, and have tentacles that extend deep into the district they represent.

9. Don't forget the little guys - Local and state elected officials carry weight with their federal counterparts (and sometimes replace them). Make sure your local and state officials understand how federal legislation affects medical care in their district.

10. Share this article - We need every practice to make their voice count.

None of these ideas are novel. Indeed, we have used them in medical practices across the country for years with success. But, unless you and your practice become involved and communicate your concerns at each and every opportunity, reform is unlikely to happen.

Lucien W. Roberts, III, MHA, FACMPE, is vice president of Pulse Systems, Inc., and a former practice administrator. For the past 20 years, he has worked in and consulted with physician practices in areas such as compliance, physician compensation, negotiations, strategic planning, and billing/collections. He can be reached at lroberts@pulseinc.com.

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