Cuts to Medicare Formula Worry Doctors

by Luke Jones  on Monday, Oct. 1, 2012 12:00 am  

For doctors, it's not the Affordable Care Act's Medicare changes causing big worries, nor is it the possibility of spending cuts through sequestration.

David Wroten, executive vice president of the Arkansas Medical Society, said sequestration was "a minimal cut" from physicians' standpoint, and the ACA would affect mostly hospitals. Doctors are instead concerned about the scheduled cuts due to Medicare's sustainable growth rate system. Currently, come 2013, the formula would slash physician reimbursements by about 30 percent.

"The sustainable growth rate is the biggest issue in the long run that we're trying to deal with," said Gene Shelby, an emergency physician at National Park Medical Center in Hot Springs and president of the Arkansas Medical Society.

That system "doesn't work," Wroten said. "It ties spending for the entire physician budget not on the cost of providing care but on an arbitrary percentage of gross domestic product. This has resulted in scheduled cuts in each of the last 10 years."

Thus far, Congress has always intervened, Wroten said, putting off the cuts because of the "devastating impact it would have on the medical profession."

It would especially harm Arkansas, Wroten added.

"Arkansas is in the position where we have one of the highest percentages of Medicare patients in the country," he said. "We also receive the lowest Medicare reimbursement in the entire country. If you go back 10 years, the cost of practicing medicine has increased 20 to 25 percent, at a minimum. That's just the cost of running a practice."

It gets worse, Wroten said: A couple of years ago, Congress intervened only after the cuts had taken place.

"It has been an absolute nightmare," he said. "It makes Medicare an unreliable payment source for physicians. Even if they postpone the cuts every year, it's unreliable because we don't know what's going to happen. That's the impact."

"Each year they put it off, the price tag goes up," Shelby said. "The leadership of the medical society met in Washington in February. We're talking to members of Congress about it."

"We're begging and pleading for Congress to fix it," Wroten said. "It's a rare issue right now that appears to be nonpartisan. Democrats and Republicans agree that this formula is out of control; it makes no sense. But until they fix the problem, we go through this song and dance every year."



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