We asked Part B News readers what message they wanted to send Congress as they faced a 21% cut to Medicare reimbursements March 1 (the cut actually happened, but Congress retroactively delayed it until April 1). Here are their answers, minus a few that were written in all caps (sorry, it's a pet peeve of mine!).
Don't do it!
It does not even cover some of the expenses for the patients. The other problem is every time Medicare lowers their rate the commercials insurers want to follow that trend. There will come a time when physicians will not be able to make enough profit to cover their expenses if a permanent stop is not made to the reductions.
The legislative branch has become an absolute embarrassment and everybody should be thrown out.
Would they be willing or able to take a 21% pay cut????????????????
Wake up guys and salvage what healthcare we have left in this country! How can the government continue to pour billions of dollars into their push for EHR but not pay providers the cost to provide basic services?
Expect a shortage of participating physicians- expect a SHORTAGE of physicians for Medicare patients.
If this doesn't get fixed, we will not be able to provide care, since we have a Medicare population of 70%.
Clinics will be more likely to limit Medicare patients, which will delay seniors' care or send patients to the emergency room, which will cause more costs to Medicare's program than paying providers what they deserve for services.
The first to go will be primary care, stressing even more an already horribly stressed system.
This will result in practices having to cap or eliminate Medicare participation. Financially, we simply cannot afford to continue to see these patients for the pennies that we receive.
Would you work for the same amount of money that you expect us to?
A 21% cut will cripple our practice because we will not be able to afford seeing MC patients. It's an absolute disappointment that our government thinks this is acceptable.
I believe they need to receive a message that the Medicare system will lose providers if this takes affect. What are they going to tell Medicare beneficiaries when they cannot find a provider?
Congress really is broken. Congress is made up of individuals. They need to be replaced by re-election.
Hopefully they are getting some expert opinions on this drastic cut. I don't believe it is going to help anyone.
The system was flawed from the start and no one in Congress or the Senate has the moral fiber to fix it. They are not representing their constituents, they are serving themselves. It's part of the flawed thinking that removes payment from the healthcare providers-the only sector of the economy that has not been devastated by the recession in order to make elected officials look good.
Shortsighted. You are paving the way for doctor shortages.
The payment system utilized by Medicare under pays providers for their services and is the driving factor behind high commercial premiums as we all need more money for the commercial services we provide to offset the government underpayment.
This will only harm our elderly population.
Medical practices and facilities are a major employer in this country. The uncertainty surrounding the Medicare cuts is contributing to the unemployment problem in the US.
A 21% loss of revenue should also translate into other governmental cuts -- including elected officials pay and staff support.
Do you want primary care physicians??? Do you want physicians at all????
We practice emergency medicine and so cannot choose to become non-participating. That means we will be there to see patients, but it will be harder to recruit quality physicians to work in the emergency departments. My non emergency colleagues, however, have told us they are cutting back on Medicare patients. You will end up with many Medicare beneficiaries being treated by lower quality emergency physicians for much of their care, since when they are sick they will go to the ER, but also when they are not that sick, they will still go to the ER, since they will no longer be able to find a primary care physician. Tell the government that we may be stuck with the government we deserve, but we don't deserve the healthcare that the government is willing to settle for.
This byzantine system must be fixed now!
The 21% SGR cut, based on admitted flawed and erroneous data, is capricious and borders on criminal negligence by our elected officials.
This will be devastating to physicians and patients as well. In an already strapped medical economy this will negatively affect all aspects of medical care.
We cannot afford to treat Medicare patients if a 21% cut is imposed.
Stop posturing, worrying about partisan politics, getting re-elected and actually do something about the Medicare payment system. This is within your control and has been for a long time.
Avert financial disaster among primary care practices and avert serious barriers to patient access to primary care by passing a permanent fix!
If not able to control the healthcare costs, government should be cutting payments.
It this is not fixed permanently to cover the costs of seeing Medicare patients we will no longer accept new Medicare patients and will gradually terminate the care of the existing ones.
The need for a permanent fix is evidently necessary so that providers can continue to provide quality care to the Medicare population and not have to be concerned about sustaining their practice.
Savings to the MCR program should not come solely on the backs of physicians. If funding for the Medicare program is necessary, then all providers (hospitals, DME, Drugs, Rehab, physicians) should share equally in the reimbursement changes. For the last several years physicians have continued to be adversely impacted when they are expected to be the key to controlling health care expense and improving the overall health of patients. This will lead to physicians limiting their Medicare patients population at a time when there are more Medicare patients then ever. Maybe Congress will notice when Medicare patients cannot find doctors to care for them.
It's broken! Medicare Advantage plans thru private insurers is not an improvement. How many private sector businesses are dictated on fees to charge; then withhold payments when they have system changes. We still owe our creditors and cannot say that "we don't have the money from Medicare" so can we delay our payment. Require accreditation if you want to set standards across the board... this will eliminate those who cannot maintain a standard and this will even out the playing field.
If CMS continues to cut reimbursement to provider we will have to find a solution for Medicare patients to receive medical care from only government employed physicians as private practice physicians will opt out of Medicare.
Effective immediately we will not accept any new Medicare patients. We cannot afford to treat them for the fee schedule proposed.
If you cut physician pay, cut yours too!
The Medicare payment system is an ancient system that needs revision. Health care reform has not addressed the issue of the insurance industry - but rather chose to cut fees to physicians, who are out there in the trenches, treating patients, running small businesses. This cut will put physicians out of business, because unlike the government, we do not utilize deficient spending. If we do not have the income to cover our expenses, we will cease to operate, further expanding the shortage of physicians. Physicians are the key to health care reform. Without physicians, the system will not function. Physicians only want to do what is best for their patients. The insurance industry has killed the practice of medicine. Physicians need to be rewarded for the job that they do - life expectancy is higher than ever - rather than penalized. Physicians should be called upon to reform the health care systems, rather than be left out. No one knows more about the health of America than a doctor. However, the industry has succeeded in dividing & conquering - physicians cannot organize and strike in protest of these practices. But they should - because without doctors, who will take care of the patients?
Some providers will stop taking new Medicare patients and some will even stop seeing existing Medicare patients. What will congress do then? Most of them had better start looking for another job because come Nov. they will be elected out of office.
We need a permanent, sustainable fix to this problem. It is the only way we can ensure that all patients will have access to competent providers.
How do you expect physicians to maintain a practice, staff and office, convert to EHR, maintain OSHA, HIPAA, CMS, IDPA, OIG and IDPH standards. This all cost money and this is way too much of a cut for an already ridiculous re-imbursement system.
If you want to completely break the system, initiate this cut. The amount of doctors opting out of the Medicare plan will be a flood. Are you willing to inform the seniors that they will no longer be able to see their physician because you failed to act.
Listen to your constituents! They don't want the expensive healthcare reform on the table, but they want Medicare fixed!!
Our practice is 50% Medicare patients, we go from six orthopedic surgeons to two or three and stop seeing Medicare patients altogether.
There will be no access to Medicare patients nationwide if a 21% cut takes effect. The medical overhead required to see patients cannot sustain that reduction in payment.
Upholding these cuts, when Medicare reimbursement is already inadequate - along with cutting consultation payments means more providers will be forced to drop from Medicare participation or limit new Medicare patients seen. We want a permanent fix, but in this political climate, don't believe this will happen, not in any meaningful way. A temporary fix should be undertaken ASAP. We should take care of the seniors/disabled folks that are already enrolled, before opening up more access. If we aren't able (nationally) to adequately fund current programs, how can we increase coverage to more citizens. Look to the grand failure of the TennCare experiment in Tennessee - noble and laudable goals, now looking at major cuts again.
We may begin by not seeing new Medicare patients; then not seeing any.
Do they realize that are over 700,000 tax paying physicians let alone their employees that are involved in healthcare in the U.S.? Without physicians there can be no healthcare. Congress is at the ready to save the financial industry however, want to balance the federal budget with Medicare cuts. How can they propose to add another $950 billion in new healthcare initiatives when they cannot pay for what was enacted in 1965? I am all for helping those that are less fortunate however, in Pennsylvania there are three programs: Medicare, Medicaid, and CHIP just to name a few. What is truly needed is to focus on the health insurance industry and hold them more accountable for escalating premiums. The Blues are considered non-profits yet, in Pennsylvania they are accruing massive reserves ostensibly to offset future claims. However, the reserves are purported to be far in excess of the actuarial reserves required. In addition, they pay themselves handsome salaries and benefits. The smaller insurance companies simply follow in the footsteps of the giants!
Our elderly deserve quality healthcare and should not be at the mercy of the government to not reimburse healthcare providers appropriately. I did not see our elected officials take a 21% cut or any for that matter.
Physicians will drop out of Medicare and there will be no decent available care for seniors. It will be a colossal mess. What business can deal with an overnight 21% of their revenue while still doing the same amount of work and incurring the same costs to do so--none!!!!!
We would like a permanent fix.
Both physicians and patients will suffer.
Make a permanent fix.
At a time when the government is encouraging medical practices to invest in healthcare IT, it is creating a climate of uncertainty that makes it virtually impossible to plan. The economy is not improving (at least from this practice's perspective) and payment delays and 30 day extensions just don't work when you have staff and suppliers to pay.
The cuts in the insurance between Medicare and managed care have forced our physicians to retire prematurely.
Just quit posturing for 24 hour news coverage and get the job done.
This should not a partisan issue. This is about providing medical services to seniors. It seems absurd for Congress to suddenly get fiscally sensitive in light of the spending in the past 12 months.
The unending request by all these various contractors for CMS puts an unending extra burden on a practice already running on bare minimum staffing.
I can foresee a time in the near future when physicians return to fee for service and refuse to participate in any insurance plans, including Medicare.
In a time when the government is trying to revitalize the economy it seems that a 21% Medicare cut will result in much of the economic progress of the last several months being lost. This is because to counter these cuts many physician practices and facilities are probably going to start cutting overhead through staff reductions resulting in more people out of work resulting in less money being injected into the economy and the cycle will continue forward. Further, how are you going to "reform" healthcare and supply better healthcare if most of your best physicians are not participating in Medicare and would be hesitant in participating in any program even associated with the government.
Think about it and fix it permanently.
Stop this now. How do you expect quality patient care when we are getting paid less than what it costs us to operate? You are asking for us to develop EMRs and other measures but how can we do this with what we are getting paid.
The health care of our senior citizens should not be left up to political whim.
I am concerned that our elected officials recognize and agree the formula for determining the Medicare payment rate is flawed yet they cannot do the right thing and fix the formula. This should not be controversial. Fix the payment formula first and then deal with the universal health care issue separately.
The continued delay over the past years has essentially caught the practice unprepared to deal with this type of financial impact. This is a particularly bad time due to the current economic status of the country. It has been acknowledged the SGR is flawed and needs to be reviewed. Why then has there not been a fix in place. If this reduction is enforced, practice may have to eliminate staff which will only contribute to the unemployment rate. In addition, practices that have continued to see Medicare patient throughout all of the changes implemented by CMS may not have to reconsider service provided and patient mix to the detriment of the elderly.
By cutting physicians fees, physicians will not be investing in new equipments & this will lead to more utilization of hospitals. Just a reminder that for same testing services, Hospital is reimbursed lot more (many tests are 150%-300% more).
So Physicians cut will back fire to the entire system & Medicare will end up paying lot more to the hospitals. Further many physician practices will not be able to survive this 21% cut. They all will be forced to sell their practices to hospitals.
Stop talking about healthcare reform and take care of business and fix the problem of the 21% cut.
Stop the insanity and fix this once and for all.
Why don't we freeze your pay for 2 weeks every other month or better yet...give back your high salary for part time work and your cars and your free trips so people that need care can get it from qualified doctors instead of docs-in-box.
The population of patient's reaching Medicare age will keep increasing with the baby boomers hitting the age group. The Medicare payment system can't keep cutting payments to providers or they will have to cut services to patients or leave Medicare altogether.
This Medicare cut has been an issue for years now. It really needs to be dealt with once and for all. A 21% cut are you kidding me. That's a very high cut that will be seen visibly in practices across America. I don't think anyone in Congress would want a 21% cut in there pay. This cut will hurt many physicians and therefore they would then become non participating which will result in access to care for the elderly.
It is understandable why so many internal med practices have closed their doors. The Medicare cut will force our practice to become non-participating providers this is sad because a majority of our practice is Medicare patients.
Of our 14 man group, several are considering retirement. Others are considering dropping Medicare patients.
We need a permanent fix to the Medicare system. These temporary fixes do not help in planning for the future.
The short term fixes were suppose to provide time to come up with a permanent solution and I don't think they have really worked to that end.
The payment cut will cause tremendous upheaval in the delivery of care to Medicare recipients. This cut should not have been allowed to go into effect! Yes there should be a long term fix but in the mean time (now probably for the rest of 2010) the cut should be eliminated. Unbelievable that our elected officials let this happen!
Stop the Cuts - We will have to rearrange staffing volumes which could result in lost jobs as well as have to cut our Medicare patient volume.
I fear that not removing the threat inherent in the reductions related to the SGR will result in physicians not leaving the Medicare program, as this negatively affects participation in the Medicare Advantage plans, but severely restricting the number of Medicare patients served by physicians. So the reduction in access for patients will not be apparent as the number of physicians may remain the same, however Medicare patients will not be seen timely.
We need to change the way fees are calculated and we need certainty in this calculation.
Help. Payments are what we use to pay our employees.
Continued uncertainty over payments to physicians and repeated cuts make it impossible for us to continue to see Medicare patients. We have severely restricted our new Medicare patients and will now stop seeing them altogether.
Medicare pays me less to see a patient than a hairdresser gets paid for a haircut! The hairdresser does not require computer billing, a certified coder or malpractice insurance. This is below minimum wage after overhead. I really think physicians should sue the government for paying us less than minimum wage.
Not fixing this problem will drive doctors out of Medicare and will cause an access to care problem for Medicare patients.
Stop playing partisan politics and get the peoples work done!
We are not supporting our physicians to take care of our elderly.
If you aren't going to pay us enough to cover our costs, then at least cover our malpractice risk.
I didn't go to Medical school to get paid less than my plumber while being responsible for human lives. Take your RAC, MAC, CERT, and your money and find another doctor. I'm out of here. I'll cut my office hours and staff, but I won't play this game.
This is the beginning of no-access to care for Medicare patients. Maybe that's the big plan- if they can't get health care, they'll die and then the cost will go down!
As more primary care physicians such as me and my 3 associates in Baltimore refuse to participate with Medicare/Tricare, those patients will have an even more difficult time finding a provider. I will be laying off additional office staff to reduce overhead and those employees will be filing for unemployment insurance and lose their medical benefits adding to the millions of uninsured in the United States who live here LEGALLY!
We are the only profession that each year gets cuts or freezes; the system doesn't even keep up with the cost of inflation and expenses; even minimum wage goes up each year; furthermore Medicare has become so difficult to work with due to regulations and policies that ultimately adds more fiscal strain on practicing physicians.
Communicate with providers before voting in something. Things can always look like a solution on paper but try it in "real" life first.
Have fun addressing all the Medicare patients who will not have a doctor willing to see them.
If the cuts go through the access to care for Medicare patients is going to drop.
Medical practices cannot continue to offer services to Medicare patients if they reduce our reimbursement. We will be forced to stop scheduling new Medicare patients.
Clean up your act NOW.
Access will suffer then they will respond.
To cut Medicare payments from physicians, especially primary care doc, is to doom Medicare patients. We will simply have to stop seeing them to survive.
If it isn't fixed, the impact on the Medicare population will be unprecedented. Quit playing politics and fix this.
As Medicare goes, so go the other payers. The proposed Medicare cut will encourage other insurers to reduce payments as well. All of the doctors for whom we provide billing services work very hard and conscientiously, and none is drawing a well-off compensation. They are all slightly above comfortable middle class. We continue to strive to ensure that our doctors are paid correctly for the services they provide, despite the errors made b y the insurance community. The proposed Medicare cuts cannot be borne by physicians. Why not take a real look at fraud and abuse by DME and home health providers??
As Medicare providers we are proud to service the Medicare population. These participants require skilled intervention that they have earned and companies, like ours have weather many Medicare storms but is getting harder with each change. Please reconsider.
Please do away with the SGR and fix the payment formula once & for all so that we do not have to spend so much time every year sweating out future cuts instead of managing our practices to the benefit of our patients. All of the drama isn't necessary; it's just a big headache.
You do a great disservice to our senior citizens by forcing practitioners to limit the number of Medicare patients we can accept and still stay in business. We can care for these patients, in a healthy, cost effective environment that has been proven to save Medicare 57% more than if done in a hospital environment.
This is one thing that is really broken and should be fixed permanently; the temporary fix is just that, a temporary fix.
It's time to stop the party bickering and really fix things.
With Medicare patient's being 75% of our patient base the hold status we are in is frustrating. Besides having a 21% reimbursement cut we are on again off again mentality.
A closer look must happen. Insurance companies need tighter rules and regulations. We have FAR too many different insurance companies/plans for the public to choice from. Several plans/policies are misleading in their coverage and are established just for that reason. Every January 1st, we have numerous elderly patients that cry, yes cry, because they signed up for a Medicare replacement plan and was not aware of the fact. They thought they were getting a Medicare supplement. The government must set tougher rules.
If you continue to cut the reimbursement of physicians, we will no longer have the excellent medical professional as we do now.
It isn't bad enough officials are not willing to pay the doctors, who take huge risks, have paid a fortune for their education, and are at the mercy of all insurance companies, the elderly patients are the ones that no one seems to have any regard for. Elected officials will never have to worry about being uninsured, don't they care about anyone else?
Many primary care practices are already hard pressed financially. The burden insurance companies put on practices in terms of billing, prior authorization and other tasks is no longer bearable. On top of that most of us have not received any increases in pay-rates, yet have to pay more every year for products and services we purchase. Our health insurance carrier wants to increase their rate by 60% for the next 12 months, but does not intend to pay us even a percent more. We will more than likely not be able to afford health insurance for our employees any more, particularly after the Medicare pay-cut.
Are you all crazy.......
Insurances have cut enough to physicians already...we are working three times as hard and seeing three times as many patients to keep us going...what next??
This issue should have been addressed and dealt with long ago. What is their excuse?
Elected officials should look for ways to help our elderly populations instead of hurting them. Many providers may opt out of Medicare because of all the governmental cuts and the regulations placed of them leaving a lot of patients without care. They can cut other UNNECESSARY spending.
Cost of healthcare does not just come from what CMS has for a reimbursement for physicians. This cut will hurt physicians and most importantly the patients. Physicians get cut on reimbursement but the cost of all supplies and employee benefits i.e. health care has gone up. Look at pharmaceutical and supply companies. The cost of a screw is over $600.
We as physicians' office should not have to go thru this every year worrying about what will happen next, it is a waste of time and energy that we could be treating patients. These cuts will cause us to cut staff which makes for less service, and longer time delay. We have already cut all of our staff to 32 hours a week, rented unused space in our office, now not sure what else is in store.
The Medicare system needs to be permanently fixed to ensure continued care for the Medicare population. Current Medicare allowed amounts do not cover a providers cost to provide care. The thought of cutting the current payments is crazy, it will leave providers no choice but to NOT see Medicare patients.
The Medicare system will be completely ruined. I think most doctors will consider not participating in Medicare; which will only hurt the elderly patients.
Congress had more than a year to repeal the Medicare payment formula and ensure the security and stability of the program. Instead, it has abandoned patients who rely on Medicare and TRICARE for their health care.
Parliamentary procedures offer no excuse for the harm they are causing these programs.
Stop playing games with patients and the physicians; repeal the sustainable growth rate (SGR) formula once and for all.
You cannot expect medical providers to go through these threatened pay cuts year after year and continue to see Medicare patients. You also cannot expect providers to lose money every time they treat a Medicare patient.
If the 21% cut isn't stopped I'm going to opt out of Medicare.
These cuts are catastrophic for Nevada residents. These cuts make practices evaluate their participating status with the Medicare program
The cut will affect our bottom line
We are a small group of seven family practice physicians in Wichita, KS. Medicare reimbursement is already too low to sustain reasonable compensation for the risks and investments these doctors make in the practice. All but 1 of our physicians is now not accepting new Medicare patients. He is also now considering not taking any more Medicare patients.
They are going to force physicians to drop out of Medicare which will affect the elderly. Aren't we supposed to be here to help people?
Use logic! Fix the problem. We can't sustain a 21.2% decrease. Why should we? We treat our Medicare patients conservatively and effectively. We love them & wish to continue caring for them.
There needs to be a permanent system in place so that every year this does not become an issue. It is hard to predict your revenue every year.
This is a terrible thing. Physicians should get reimbursement for their services. With all the mandatory EMR's, E-Prescribing to save the government money, which costs practices millions, and then a pay cut of 21% !! Our physicians are outraged! To say the least.
Medicare should support the patients who have worked for years to maintain this country's industry, and there care should be of primary focus to ensure quality and availability. More physicians will not accept Medicare if they can not support their practice due to cuts in reimbursements.