Medicare Payments for Imaging, Specialists Slashed Under Proposed MPFS
As part of the continuing push to reform health care, the Obama administration has announced a proposal to decrease Medicare payments for imaging services and to specialists such as cardiologists and radiologists, and use the savings to increase payments to primary care physicians.
Physicians who pursue careers in primary care may be compared to law school grads that join public interest associations – i.e,. they are foregoing the hefty paychecks of their peers who enter more specialized fields. For example, family medicine doctors earn an average of $185,000 per year, while specialists like radiologists or cardiologists can earn twice that much. However, the waning interest in primary care has led to a decrease in the number of primary care physicians, which is cited as one reason for the nation’s health care crisis. Specifically, patients without a primary care physician typically do not receive the type of preventative care that is essential to good health, such as cholesterol monitoring, smoking cessation guidance, or health management.
Take the following as an example – suppose Joe (let’s call him “Joe the Painter”) develops a nagging cough. He tries to make an appointment to see one of the few primary care physicians in his town who accept his insurance, but cannot get an appointment for several weeks. Joe decides he will just “tough it out” and hopes the cough will go away. Unfortunately, the cough gets worse. When Joe finally does get in to see a primary care doctor, the cough has evolved into severe bronchitis and Joe must be hospitalized. Joe spends several days in the hospital and receives thousands and thousands of dollars of medical treatment. As it turns out, his bronchitis was caused by a minor virus which could have easily been treated with an inexpensive antibiotic that his primary care physician could have prescribed.
Under the Obama administration’s proposal, starting in January of 2010 Medicare would attempt to place payments to imaging services and specialists on par with those provided to primary care doctors. This change is estimated to boost payments to internists, family physicians, GPs and geriatric specialists by 6 to 10 percent. Payments to cardiologists would be trimmed by 11 percent overall – which has been met with a less than enthusiastic response from cardiology associations.
The proposal, which is open for public comment until Aug. 31 and is expected to be completed by Nov. 1, is part of the Center for Medicare and Medicaid Services (CMS) 2010 Medicare Physician Fee Schedule. The Obama administration is already spending $500 million in stimulus funding to train more primary care physicians and offer student loan forgiveness for primary care doctors who work in underserved areas.
