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Physicians see expected 10 percent Medicare cut

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Centers for Medicare and Medicaid Services (CMS)
American Medical Association (AMA)
quality measures
Medicare
medicare reimbursement
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Unless something dramatic happens, it appears that physicians will see Medicare reimbursement cuts of almost 10 percent in 2008 under a final rule issued yesterday by CMS. The cut is driven by the sustainable growth rate (SGR) formula used by Medicare, which could lead to Medicare cuts of more than 40 percent by 2015 unless replaced. The rules also add more quality measures to CMS's existing Physician Quality Reporting Initiative, which offers physicians a 1.5 percent bonus if they voluntarily report on performance.

Presumably, the MGMA, AMA and other physician groups will pressure Congress to do as it has previously and adopt measures to hold off the payment cuts. It's not clear, however, whether the political will is there in Congress to hold off cuts this time. This is definitely a cliffhanger.

To learn more about the cuts, and related rule changes:
- read this Modern Healthcare article

Related Articles:
Physician Medicare cut may be eliminated. Report
Medicare plans physician service fee cuts. Report
A different perspective on Medicare cuts. Report
CMS to phase in cost-weighting payments over three years. Report
Physician groups not thrilled with Medicare deal. Report

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This is really unfortunate. I know of several physicians that I work with who will be closing their doors to new medicare patients. Some may wrongly conclude this is just greed on the part of doctors. Its really about the physicians ability to deliver quality medical care however. Medicare patients are a very complex group of patients. Life expectancy is higher, there are new drugs to treat new conditions. These patients are frequently hospitalized and move from care setting to care setting (hospitals, nursing homes, Rehabs etc). They frequently require state-of-the art diagnostic testing. Keeping track of all these issues, dealing with long family visits, phones calls, coordinating care is all too time consuming. With decreasing resources, there is a limit to how far a physician can extend themselves.
Mark Singh MD
www.clinicore.blogspot.com

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