Skip to main content

CMS 2012 Draft Payment Rules: Automatic Triggers Cause Huge MD Fee Cut


Today’s Managing Health Care Costs Indicator is $330 billion


The Centers for Medicare and Medicaid Services issued its draft 2012 payment rules yesterday. The  payment rules give modest increases to ambulatory facility fees, tie ambulatory surgery fees to quality reporting, and make some much-needed changes in imaging reimbursement.  

The headline is that these draft payment rules cut physician fees by almost a third, as required by the sustainable growth rate formula.   This is the automatic trigger that has been overridden by Congress every year (or more) since 2002.   Just about no one thinks this is a good idea.  Physician payment increases in Medicare have been substantially less than those offered by other payers, and in some communities it's hard to find a physician taking new Medicare patients.  

Click to Enlarge  Ginsburg, New England Journal 12/10 

The cost of physician services keeps on going up, and no efforts to lower utilization have worked - so the blunt instrument of threatened massive payment cuts continues to hang over physicians' heads.  The 10 year cost of eliminating the SGR payment cuts would be $330 billion.  

There's a lot of talk in Washington about establishing automatic triggers to prevent the government from overspending.   The SGR is an example of such an automatic trigger that has been in place for some time, through Democratic and Republican administrations and Congressional majorities.   We've proven in health care already that these triggers only work if they make sense and there is enormous political will to support them.  A singular problem with the SGR is that cutting physician unit payments is not an especially effective way to lower overall health care costs.

There has been an enormous amount of lobbying to reverse these cuts over the past decade.  We should expect a similar response to future cuts in government spending triggered automatically, especially those that don't make political or economic sense.
Labels:

Comments

Post a Comment

Popular posts from this blog

clip on magnetic sunglasses visit here

Save with prescription glasses and sunglasses. Prescription eyeglasses with magnetic clip on sunglasses. A wide selection of colors and styles for every budget! -GlassesPoint. Prescription eyeglasses with magnetic clip on sunglasses. A wide selection of colors and styles for every budget! Free magnetic clip on with every pair of glasses.  The operator should contact lens Plano glasses a few days of Sun and Rx on the other person. Many people choose single vision lenses, designed for a specific use, such as prescription sunglasses. Clip-ons magnetic magnetic clip ons often come with their prescription glasses frames. Prescription glasses Goggles4u dollars from 29.99 with free shipping. Takumi neodium magnet glass features recipes that are light, strong and in. The combination of some normal prescription glasses and a pair of polarized glasses that glare-resistant to outdoor activities. clip on magnetic sunglasses visit here
Post a Comment
Read more

The Tragedy of Underfunded Mental Health Care

Today’s Managing Health Care Costs Indicator is   19,900 The NY Times  on Friday had a deeply disturbing article on a murder that stunned the mental health community here in Massachusetts.    A long-term schizophrenic man, off his medicine and spiraling into incoherence, killed a young female counselor who was the sole worker at a group home in a Boston suburb.   His mother, who works at a Boston teaching hospital, was frantic with worry as her adult son, who had been arrested for assault multiple times, was becoming more psychotic.    It was hard for her to get anyone’s attention. The counselor was the first in her family to get a college degree, and had just decided to go to nursing school.    Now she’s dead – and her family had trouble scraping together the resources for a burial.   The schizophrenic will be imprisoned for the rest of his life – which ironically could be the best chance for him to get appropriate medical care. Both...
Post a Comment
Read more

How a Well-Intended FDA Policy on Colchicine is Harming Patients

The road to hell is paved with good intentions. The FDA has reaffirmed the truth of this aphorism with its policy about Colchicine. Here's the story: I recently spoke with a friend who has a family member suffering from Familial Mediterranean Fever (FMF), an auto-inflammatory disorder, most commonly seen in eastern Mediterranean populations. The condition is characterized by recurrent painful inflammation of the abdomen, chest and joints, accompanied by fever. FMF is associated with mutation of a gene on chromosome 16 involved with regulating Pyrin, a protein that is part of the inflammatory response. There is no specific test for the disease. Diagnosis is made on the basis of symptoms, family history, and ruling out other conditions. Since the 1960s, Colchicine, a plant extract first used for treatment of gout two thousand years ago, has been used for treating FMF. As an ancient treatment widely used prior to formation of the FDA, Colchicine did not require FDA approval as a new ...
Post a Comment
Read more