While the news of increased efficiency and quality in care in the Medicare program is a good thing on the surface, the fact that Medicare doctors are facing a 30% cut in pay leaves one wondering about the real fate of Medicare reform. There are a lot of pieces to this puzzle and if you really want to be informed about what is happening, you are going to have to dig deeper into the problems Medicare is facing. For example, do you know what the SGR formula is and that it plays a big role in the success of Medicare reform? Did you know that Medicare trustees predict that spending under Part B is expected to increase by more than 4%? Take a look at the article below written by David Glendinning for amednews.com to learn more.
Washington Medicare’s fiscal caretakers warn that the already dismal view they have of the entitlement program’s long-term financing is probably overly optimistic given that it relies in large part on reduced payments and increased efficiency-of-care assumptions for health professionals that might never become a reality.
In their annual report on the state of the program’s finances, Medicare’s trustees project that outpatient care spending under Part B will increase by an average of 4.9% annually during the next five years, a full percentage point lower than the 5.9% average seen during the past five years. But the estimate assumes that Medicare pay to physicians will be cut by 30.9% in January 2013 under the sustainable growth rate formula. If Congress overrides the SGR cut, the trustees say average annual Part B spending growth going forward will jump to 7.6%.
“It is a virtual certainty that lawmakers, cognizant of the disruptive consequences of such a sudden, sharp reduction in payments, will override this reduction just as they have every year since 2003,” the trustees state in the 2012 report.
The Part B projections also are influenced by the Budget Control Act of 2011, a sweeping deficit reduction measure that will reduce total Medicare spending by as much as 2% starting in January 2013, a mandate that could squeeze physician pay even more on top of the SGR cut. So far, lawmakers have failed to agree on more targeted reductions to replace the across-the-board spending cuts to Medicare, defense and other nondefense programs. If they cannot do so by the end of 2012, the automatic reduction process known as sequestration will begin.
Medicare doctors are facing a 30% cut in pay and they are still expected to increase the quality of their services. The path certainly seems unsustainable, but again, we encourage you to stay abreast of the current news. If you have a good relationship with your doctor, don’t be afraid to come out and ask what this means for you and your care.