Cuts In Medicare Reimbursements By ACP Forecast To Accelerate Collapse Of Primary Care

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Primary Care / General Practice
Article Date: 06 Nov 2007 - 7:00 PDT

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The American College of Physicians (ACP) has renewed its call on Congress to replace the 10.1 percent devastating cuts in Medicare reimbursements set to take effect Jan. 1 with at least two years of positive updates that are paid for in a way that does not make the problem worse in future years. The organization of 124,000 internal medicine physicians, related subspecialists and medical students reacted to the final physician fee schedule published late last Thurs. by the Centers for Medicare & Medicaid Services (CMS).

"The cuts will accelerate the collapse of primary care, create access problems and manufacture obstacles to fundamental reform of physician policies," emphasized ACP President David C. Dale, MD, FACP. "It is essential that lawmakers agree on an immediate fix that will provide positive and stable updates, support patient-centered care coordinated by a personal physician, and create the building blocks for long-term reform of a flawed payment system."

More than half of physicians say they will have to limit their acceptance of new Medicare patients if payments are cut as projected in 2008, according to a survey conducted by the American Medical Association, and two-thirds of physicians say they plan to defer purchasing information technology. Physician payment rates are about the same today as they were in 2001, while a typical practice's costs have increased nearly 20 percent during that same time period, it said.

"Prior to its August recess this year, the U.S. House of Representatives took action to ensure our seniors retain access to high-quality health care," Dr. Dale noted. "The legislation replaced projected 15 percent cuts in Medicare payment rates for all physician services over the next two years with positive updates of 0.5 percent. Importantly, it also provided $20 billion in offsets to pay for positive updates instead of using budget gimmicks that, experience has shown, would only make the problem harder to solve in subsequent years."

Medicare patients and the physicians who provide care for them are asking that the Senate embrace similar legislation, ACP pointed out.

Temporary congressional interventions to prevent past cuts have resulted in updates that have not kept up with increases in medical practice costs and have pushed the cost of fixing the physician payments to future years, making a meaningful long-term resolution more expensive. The main reason physicians are facing a 10.1 percent cut in 2008 -- which is almost double the cuts physicians faced in 2006, the last time Congress passed legislation to forestall scheduled SGR cuts -- is because the 109th Congress did not provide adequate funding to pay for a short-term fix to the scheduled cuts in 2006 and 2007.

"Coming up with a one-year fix to the problem that makes the cuts worse in future years is not the solution," Dr. Dale continued. "We have been fighting this annual battle over-and-over again for seven years now. The Senate needs to join the House in passing legislation that will pay for positive updates in the next two years. In the long term, more fundamental reforms of Medicare payment policies will be needed."

"The huge cuts scheduled to come in less than two months will be devastating to Medicare patients' access and quality," Dr. Dale concluded. "Our patients need immediate assistance and a long-term solution."

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The American College of Physicians is the nation's largest medical specialty organization. Membership is composed of 124,000 internal medicine physicians (internists) and medical students. Internists provide the majority of health care to adults in America. Internists are specialists in adult medicine and provide comprehensive care to adult patients.

Source: David Kinsman
American College of Physicians

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