Are we ready to deal with the outcome of a 26+% Medicare payment cut to doctors? This most recent article indicates we are heading for this cut again after the New Year. http://www.medpagetoday.com/Washington-Watch/Washington-Watch/36644
Internal Medicine of Southwest Florida is under water in this equation as Medicare payments account for well over 80% of revenues. I would welcome my seasoned clients (Medicare beneficiaries) comments on how we are to pay for services if these cuts happen. Remember current law states doctors can’t participate in Medicare and its mandated fee schedule and bill patients more than what the government decides. Dont bother suggesting the obvious which is for us to keep our fee schedule and let the customers pay the difference, that isn’t how socialism works. So the questions become: 1) Do we opt out of Medicare? 2) If we do will patients want our services at market prices? 3) What are market prices? 4) Do we charge membership fees annually in order to “take orders” on demand? 5) Do we continue to offer all our services as we presently do and if so will customers pay for them out of pocket or will they insist on taking these services out of the office and over to the national reference labs and (better paid) hospital owned radiology centers (or more likely, the emergency room)?
So here we are, Medicare has become an unaffordable health care delivery system for all persons 65 and over in the US. How to we move forward? I have indicated in numerous pieces over the past couple of years that balance billing seems to me to be the fairest, cleanest and efficient solution http://thedoctorsreport.wordpress.com/2012/12/20/balance-billing-is-key-to-medicare-debate/#more-514. Have you demanded your representatives to buck up and legislate this option? What is America going to do when the doctors have to quit the program (for real)? How fast can we import physicians from other countries who will be willing to now come here for 26+% less pay?
-Raymond Kordonowy, MD