Insight, analysis & opinion from Joe Paduda

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Jun
25

Medicare physician reimbursement increase passes

Yesterday the House passed legislation increasing Medicare physician reimbursement till November 30, when it is slated to drop by 23%. Then, barely a month later, physicians will see another cut which will cut their pay by another seven points.
The temporary fix will increase payments by just over two percent.
For six months.
Then the whole debacle/fiasco/mess will resurrect it’s ugly head and we’ll be right back where we are today, except the cost of an ultimate fix will then be close to $300 billion.
But that will happen after the fall elections, and well before the 2012 voting season starts.
On the workers comp side, several states will see their doc fee schedules change in step with Federal reimbursement, while the impact on most jurisdictions’ fee schedules will play out over time as regulators and legislators work thru the politically-charged process, alter conversion factors and assess their potential impact on access and cost.
The indirect impact is likely to be much more significant as physicians and other providers billing CPT codes seeking to maximize reimbursement from private payers to offset (inflation adjusted) losses in revenue from the Feds.
For those interested in more detail, click here.


Joe Paduda is the principal of Health Strategy Associates

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A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.

 

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