Gary W. Floyd
As physicians, we solve problems, diagnose our patients’ ailments and find cures. We establish a treatment plan.
Imagine if your problem persisted for 20 years without a solution; you could look for another doctor.
Yet every year, this is the scenario physicians face with Medicare’s failing physician payment system: For more than two decades, Congress has failed to find a stable and appropriate solution for physicians to continue. care for the country’s most vulnerable patients – the elderly and people with disabilities. .
Here we go again: Without congressional intervention in the coming weeks, doctors caring for Medicare patients will see a cumulative payment reduction of about 8.5% starting in January.
Can doctors leave the program? Yes. But most of us choose not to because we love taking care of our Medicare patients. Doctors, however – like any other business – have their breaking point. In the face of high inflation, the “Great Resignation” and ongoing pandemic pressures, that may well be it for doctors.
The culprit is a patchwork of Congressional Medicare policies that care more about the budget than doctors and patients. When these policies don’t keep pace with Medicare spending, physician payments end up on the chopping block. The cuts are usually 4% here, 3% there, but they add up to an unsustainable system that stings our medical practices trying to stay viable.
Medicare’s physician fee schedule fails to keep up with inflation. When adjusted for inflation, Medicare payments to doctors have decreased by 22% from 2001 to 2021. Meanwhile, the consumer price index for medical care in US cities has increased by 95% in during the same period, according to the US Bureau of Labor Statistics. (Imagine those numbers amid current inflation rates.)
In the meantime, other health care providers who also care for Medicare patients – hospitals, nursing homes, etc. – have seen their salaries increase. Again, they are slated for modest increases in 2023.
Instead, every year — for decades now — we’ve had to beg Congress for emergency fixes to pull patients and their doctors from the brink — because we don’t have a permanent fix and steady.
The result: Doctors caring for frail patients essentially lose practice revenue every year.
These ever-increasing wage cuts are jeopardizing practices – and patients’ access to care.
Medicare patients and their doctors deserve better!
Nearly one in five Americans is covered by Medicare (nearly 20%). They are the most susceptible to chronic diseases and infectious diseases like COVID-19. You probably know them; they are your loved ones, your family members. Or maybe you.
Medicare patients rely on their doctors when they need them most in clinics and hospitals. Doctors attend to the health care needs of these precious patients, managing their blood pressure and medications. It is our honor.
But this endless situation – on top of the pandemic stress and fatigue – is infuriating. Physicians may have to cut spending because of this. When doctors faced the same hullabaloo last year — a 10% Medicare cut on Jan. 1, 2022 — they told a Texas Medical Association inquiry they were considering not accepting new Medicare patients. , opting out of Medicare, retiring, or ending existing relationships with Medicare patients. A total of 93% of physicians said they were accepting Medicare patients at the time.
I fear the same answers if I asked my colleagues in Texas what they would do if Congress authorized that 8.5% cut in January. The likely result: fewer doctors seeing Medicare patients, smaller teams, and longer patient wait times.
The TMA, the American Medical Association and other medical societies are calling for comprehensive and permanent health insurance reform. Patients and their physicians deserve a stable, reliable, and predictable Medicare physician payment system.
Failing that, House Resolution 8800, the Health Care Provider Support Act of 2022, offers temporary relief. Congress should pass this to preserve patient access to care for now.
Ultimately, Medicare patients and the doctors who care for them need Congress to work with doctors to establish a permanent solution to this recurring problem – to stabilize Medicare doctor payments to avoid this uncertainty, this annual drama and fear.
It is time for Congress to act.
Gary W. Floyd, MD, is president of the Texas Medical Association and a resident of Corpus Christi.
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