Physician Angst Over Future Incomes

Fiscal Crisis, Threat of Sequestration Cause Provider Angst

Title of November 30 Kaiser Health News Story

December 1, 2012 -  Call it what you will – anguish, agitation, anxiety, dread, disquietude, distress, fretfulness,  inquietude, malaise, perturbation, torment, unease, vexation, worry, fear. 

Or call it distrust of politics, gridlock, and compromise.   Politicians are going to have to cut Medicare pay to cut the budget deficit,  and it is easier to slash physician and hospital pay rather than Medicare benefits and to tax "the rich."  It’s simple math. Who has the most votes? There are less than 1 million physicians, and more than 50 million Americans receiving Medicare benefits,and 97% of Americans have incomes of less than $250,000. 

 Or call it history.  Ever since the Sustainable Growth Rate (SGR) formula was introduced in 1997, Congress has kicked the can down the road when it comes to ending the unworkable SGR.  

Or blame it on the fiscal cliff, as National Public Radio did in a November 30 picce “A Huge Pay Cut for Doctors is Hiding in the Fiscal Cliff.”  

Or invent your own scenario with a title like “It’s Over the Cliff and Through the Woods to the Nanny State.”

Or you just might read the following Kaiser Health News to grasp the nearness of the cliff and the depth of the abyss.

“If the ‘fiscal cliff's’ scheduled cuts take effect, physicians will face a 2 percent reduction in Medicare reimbursements. Separately, however, they also are confronting a 27 percent pay cut as a result of the failure to fix the Medicare physician payment formula.

Politico: Providers: Doctors Face 'Worse' Fiscal Cliff
As the nation hurtles toward the fiscal cliff, doctors are staring down a much more daunting abyss, a panel of experts said Thursday at Politico Pro's health care breakfast briefing. Not only do doctors face a 2 percent cut in Medicare reimbursements because of the failure -- thus far -- to avoid sequestration, but they're also looking at a 27 percent reduction in pay in the absence of a deal to fix the Medicare payment formula (Cheney, 11/29).

Modern Healthcare: Fiscal Cliff For-Profit Providers: Fitch
For-profit providers face the greatest risk from slashed spending and tax hikes known as the fiscal cliff, one major credit rating agency said in a newly released outlook for the health care industry. For-profit providers could see lost revenue under a scheduled 2 percent Medicare pay cut and a slump in business "should elements of the fiscal cliff reduce economic activity and increase unemployment," Fitch Ratings said in its 2013 outlook for for-profit health care, which includes acute-care hospital operators, drug and device manufacturers, diagnostic and life science companies and the health care service sector. Overall, the weak economy and fiscal cliff will drag on health care growth despite an aging population, the chronically ill and demand from emerging markets, the report said. The sector's outlook is stable, Fitch said (Evans, 11/29).

Modern Healthcare: AHA Warns On Impact Of Rate Cuts For Hospital-Based Docs
Congress is focused on using a $7 billion reduction in Medicare evaluation and management payments for hospitals as a way to help pay for delaying a looming physician pay cut, according to hospital officials and advocates. The long-discussed reduction in evaluation and management rates for hospital-based clinicians to the level paid to office-based physicians has gained traction with members of Congress as a way to help offset the estimated $25.2 billion cost of a one-year patch for the sustainable growth-rate formula. …The country's largest hospital group brought about 150 executives to Capitol Hill on Thursday to warn lawmakers about the impact on hospitals of the proposed evaluation and management cuts, among other cuts (Daly, 11/29).

Politico Pro: AHA: Don't Trade Hospital Cuts For Doc Fix
Hospital officials complain that Medicare already underpays them, and they're worried that an idea that was proposed by the Medicare Payment Advisory Commission -- and could be adopted by Congress -- would further reduce what they pocket for nonemergency doctors' visits. Representatives from hospitals in Mississippi, Maine, Pennsylvania and Oregon spoke at the Rayburn House Office Building about how the proposed cuts would affect their services. ... The recommendation would cut hospital reimbursements by 68 percent to 80 percent, the hospitals say (Cunningham, 11/29)

CNN Money: Medicare Patients At Risk Without Doctors' Fiscal Cliff Fix
As lawmakers head into talks to avoid the fiscal cliff, doctors are watching closely. Thanks to bad timing, the Medicare fees that doctors are paid for treating seniors has gotten tangled up in the same high-stakes deal-making to avert the fiscal cliff -- across the board tax hikes and spending cuts that kick in January. If Congress does nothing, doctors will be reimbursed 27 percent less than current rates, starting Jan. 1. That could spur thousands of doctors to stop seeing Medicare patients. It's not a situation any politician wants to see. So, Congress will likely find a way to keep rates from going up in 2013, experts from both political parties say. The question is when and how (Liberto, 11/30)."

Tweet:   Doctors are worried about what happens to their incomes if  we go over the fiscal cliff on January 1, 2013 & sequestration kicks in as well.