Physicians have received a stay of the scheduled reduction in Medicare reimbursement rates:
March 29 (Bloomberg) — Doctors slated to have their Medicare reimbursements cut 21 percent on April 1 got a reprieve from the Centers for Medicare and Medicaid Services, which is delaying lowered payments until after Congress reconvenes.
The agency, which administers the U.S. health program for people 65 years and older and the disabled, has ordered that claims submitted on or after April 1 be held for an added 10 days before being paid, said spokesman Peter Ashkenaz. That’s on top of the 14 days the Baltimore-based CMS usually holds claims.
The decision delays scheduled reductions in Medicare payments until after Congress reconvenes April 12. Lawmakers have put off those cuts every year, except one, since they were introduced as part of the Balanced Budget Act in 1997. The American Medical Association says the reductions will make doctors less willing to accept Medicare patients and is pushing lawmakers to increase payments.
This should surprise no one.
However, it does pose quite a dilemma. One the one hand as the AMA warned these reductions might well cause physicians to be reluctant to take Medicare patients. But on the other without these cuts (and future reductions in reimbursement) the prospects for cost control in healthcare look very dim, indeed.
Frakt has been doing some nice writing on cost shifting. If they were to go through with the cut, unlikely methinks, it should be interesting to see the effect on reimbursement rates by private insurance. At any rate, if there are any cuts, I think it will be limited to specialists. The ACA increases Medicare reimbursement for primary care.
Steve
Frakt that!
Steve, man, wasn’t this one of those things that is supposed to save us money? Reducing Medicare expenditures? What gives?
I think you were a tad to pie-in-the-sky in regards to the cost cutting measures of the recent HCR legislation.
Steve- Yup, but this was the one area I was figuring was a real problem. The other Medicare stuff is much easier, like Medicare Advantage. The problem with the physician pay is something that neither party wants to touch, so they just keep passing it on. When they decide to actually do something about this, I suspect it will mostly affect specialties and will be a more gradual cut than 21% at once. I remain focused on the long term, so a temporary setback here is not a killer IMHO.
Steve
Every year but one though…I’m thinking that unless we get an exceptional class of politicians in Congress we are pretty screwed.
Or, take it out of their hands as much as possible. It will take quite an effort to overturn the Advisory Board. I am counting on the continued inability of the two parties to unite on anything, though you may be correct that spending money is the one thing that will bring them together.
Steve
The Advisory Board is all but certain to run into a problem with regulatory capture. It won’t restrain costs.
Bunch of optimists aren’t we. Capture is possible, but in this case less likely IMHO. The capture in the financial system has flourished because, among other things, it was done in secret. No one knew what was going on. The decisions of this board will be very public and they will have the explicit goal of cutting spending.
Steve
The Federal Reserve Board has two mandated goals: securing the banking system and increasing employment. There’s many a slip betwixt cup and the lip.
Governor Mishkin thinks their mandate is (from a 2007 speech);
“to promote effectively the goals of maximum employment, stable prices, and moderate long-term interest rates.”
Wikipedia says.
“maximum employment
stable prices
moderate long-term interest rates
promotion of sustainable economic growth”
Looks like some potential for conflict. If the Advisory Board is given the dual mandate of keeping Medicare expenditures down and maximizing physician/hospital growth or employment, it will fail. If it is given the single task of controlling spending, it has a chance.
Steve
It is never out of their hands. They can always “take it back” and if the heat gets too much, they will. Really, there isn’t much the government can’t do these days.
No it wont. All it will take is for enough Congressmen to feel that their positions have become untenable for them to move in the direction of neutering the Advisory Board. Appeals to emotion are like lies. They spread quickly and rapidly. Relying on logic on the other hand is like telling the truth, it hasn’t even got its boots on when the appeal to emotion first hits the ground running.
This is why every politician has his “sad sack” case that he display on stage (preferrably national television). It cuts out the legs from his opponent in terms of responding in the negative. The opponent is left only with trying to one-up the initial appeal to emotion. Go back and listen/read Obama or McCain speeches and see how many of them reference the sad sack case. It is a type of poverty porn.
Dave,
I know you’re busy but wanted to point you to this and this on topics you’ve covered here recently.