JANE SCHNEIDER

Physicians from across Tennessee are expected to join colleagues from around the nation during the next several months, lobbying Congress to voice their dissatisfaction over Medicare’s proposed reduction in physician reimbursements.

News of the proposed reimbursement cut was released in early March. Under the current schedule, Medicare payments to physicians will be cut 10.6 percent below current levels on July 1. The report came in response to the President’s budget proposal, which calls for reducing Medicare spending by $560 million.

The American Medical Association (AMA) wrote a draft letter to the Senate Finance Committee urging the committee to develop a sustainable growth rate provision that “properly funds a solution to this problem and does not rely on ‘balloon’ financing.” Cardiologist Dr. Keith Anderson, president of the Memphis Medical Society, said the AMA is on top of the matter, “but right now, there’s a lot of silence on the Hill regarding what will happen when this comes up in June.”

Russ Miller with the Tennessee Medical Association (TMA) pointed out that “every year Congress puts it off, the cost of fixing it goes up.” Miller insisted that Congress recognizes the funding formula is wrong, but members won’t do what it takes to right the ship.

According to Anderson, the stress that low Medicare reimbursements place on Memphis’ healthcare providers is already beginning to show.

“Try to get new a Medicare patient in with a doctor. If you’re looking for one, you’ll come up with a big zero,” said Anderson. He said a practice in Memphis with 18 primary care physicians was one of the few groups he was aware of that were continuing to accept new Medicare patients a year or two ago. But as of January, those existing patients were being told they would have to begin looking for a new care provider.

“This is hard on doctors, but healthcare is a business and they’re losing money,” Anderson said. And this comes at a time when practice costs keep climbing. The combination of medical liability insurance, compliance with OSHA, and the cost of complying with HIPAA rules all make running a medical practice more cost prohibitive. Which is why talk of further slashing physician reimbursements is raising red flags for both practitioners and patients.

Further complicating matters is the fact that nearly 40 percent of Tennessee’s practicing physicians are over 50, nearing an age which many begin to consider lowering their patient care activities. Anderson said rather than accepting new Medicare patients or taking a cut in reimbursement fees, some doctors, who are already nearing retirement, could just quit practicing altogether.

“Congress needs to fix the formula, it needs to be overhauled altogether,” said ophthalmologist James Fleming, chair of the TMA’s delegation to the AMA. A Medicare bill is being weighed by Senate Democrats that would include a provision to prevent the 10.6 percent reimbursement reduction, but no word yet on whether that would have support across the aisle. “Congress won’t fix it because it impacts the budget, that’s why they’ll only fix it on a year-to-year basis,” noted Fleming. “But it’s a problem that becomes more substantial each year. It needs to be addressed.”

Anderson said when he and fellow physicians go to Washington to buttonhole Tennessee legislators like Congressman Steve Cohen, the politicians acknowledge that the Medicare funding formula is a problem but they don’t offer any practical solutions. “They’re going to keep cutting physician’s fees until there’s a crisis,” he said.

That’s not the kind of news the Baby Boom generation wants to hear as they begin requiring more services from health care providers. Legislators are expected to debate the reimbursement issue in June. Stay tuned.



April 2008