Fortunately in the “eleventh hour”, President Obama and Congress consented to renewing the Doctor Fix for another year.
This is an agreement to avoiding the 26.5% slash in Medicare reimbursements that is mandated by the SGR (sustainable growth rate formula). The fiscal cliff is also averted by postponing the added 2% sequestration in Medicare reimbursements by 2 months. If this was not approved, physicians and other healthcare providers would be subject to a 28.5% decrease in Medicare payments.
As you may have read, the Medicare payment formula is established to have reimbursements match gross domestic product growth. If expenses top the target, Medicare tries to get back the difference by slashing doctor reimbursement. The difference between actual spending on rendered doctor’s services and the targeted spending number is increasing exponentially.
While the Doctor Fix has been approved each year for the last 8 years or so, each time doctors are made to sweat it out with reimbursements delayed by months until negotiations are settled. According to President of the AMA,Jeremy Lazarus, M.D.:
“This patch temporarily alleviates the problem, but Congress’ work is not complete. It has simply delayed this massive, unsustainable cut once and for all.”
The reprieve is more essential for seniors and families of the military than for doctors themselves. This is because if the pain of decreased funds increases beyond survivability, the healthcare providers will simply refuse to accept new Medicare patients or refuse to participate in the Medicare program all together. This will make the whole healthcare coverage for those over 65 and military families completely crumble. Especially buy dulera inhaler with thousands of baby boomers becoming eligible for Medicare now every day. (what good is it if there are no Medicare doctors to care for them?)
Board chairman of the American Academy of Family Physicians, Glen Stream, MD,MBI,FAAFP identifies the legislative outcome as “a reprieve for elderly and disabled patients whose healthcare security is jeopardized by continual threates to Medicare physician payment but the current system, with its deeply flawed sustainable SGR formula generates a crisis of confidence among elderly and disabled Medicare patients and their physicians. Now is the time for Congress to follow through on previous promises and commit to permanently end the ordeal of temporary patches that ultimately drive up the cost of a meaningful solution and destablized the Medicare payment system”.
The thing is, every time the threat looms of Medicare slashes, more physicians analyze their bottom line and try to figure out whether they can afford to or survive under the decrease in payments…and a few more leave the system.
Can we really afford to keep dangling this threat and fear over the heads of those we need to care for us?
Well, at least we have dodged the bullet for now!
Comment on what you think of the system and whether Congress should do away with the SGR formula. Do you think it is the system and big Pharma that is driving the prices or do you think it is the doctor to blame? How about liability? Do you think that this is a major culprit in the rise of rates?
Let’s hear from you!