Medicare Cuts Threaten Specialty Practices Nationwide

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The COVID-19 pandemic has dropped at the forefront inequities and vulnerabilities which have at all times existed in our healthcare system. But, because the pandemic persists, insurance policies that additional restrict entry to look after underserved populations proceed to be pushed ahead.
For a couple of yr now, suppliers have been ringing alarm bells about devastating cuts to Medicare funding for specialty care providers directed by CMS. The 2022 Medicare Doctor Charge Schedule last rule issued in November proposes reimbursement cuts of 20% that can hurt a big number of office-based specialists treating most cancers, vascular and coronary heart illness, dialysis sufferers, and extra. The cuts will power free-standing medical clinics to shut their doorways, decreasing remedy choices for sufferers and, in lots of circumstances, leaving hospital-based care as the one choice, regardless of the already present pressure on hospital assets.
Some declare the scientific labor pricing updates within the 2022 Doctor Charge Schedule will assist deal with workforce shortages amongst nurses and different scientific employees. Nonetheless, that is primarily based on the false assertion that employees will not get pay raises in 2022 if scientific labor pricing is not up to date. Salary data from the final 20 years exhibits that Medicare’s scientific labor pricing does not dictate what medical doctors really pay employees.
Additional, proponents of the scientific labor cuts acknowledge that Medicare’s funds neutrality necessities will result in fee reductions for a lot of procedures, however they do not deal with how the specialty practices performing these procedures will make up for misplaced income. By ignoring the dire penalties for specialty practices, they’re leaving a vital sector of the healthcare system out of the equation. With the scientific labor pricing in impact, specialty scientific employees will not be getting raises — they’re going to be dropping their jobs as facilities inevitably shut.
With hospitals throughout the nation overwhelmed, it is a notably grim time to power the closures of specialty practices that present a measure of aid to each the affected person in addition to these overburdened hospitals. Sufferers who’re grappling with critical sickness should face the added well being danger of looking for remedy in a hospital setting.
Within the long-term, these slashes in funding will speed up the consolidation of our healthcare system, which limits affected person alternative and drives up prices for everybody. Giant hospital methods are already devouring doctor networks and office-based specialists in an effort to seize a bigger portion of the pie. The CMS-directed cuts will solely serve to assist these organizations achieve extra market share and additional drive down competitors, which is able to result in elevated healthcare prices. Small, office-based healthcare suppliers can’t keep in enterprise with out affordable reimbursement charges from the federal authorities.
Most of the diseases handled by specialty clinics disproportionally have an effect on underserved populations already struggling to entry care. To be clear, these funding cuts will possible result in worse well being outcomes for Black, Hispanic, and Native Individuals — exacerbating present inequities. Simply accessible outpatient care facilities in underserved communities may very well be shuttered completely.
Fortuitously, Congress has the chance to stop these critical adversarial outcomes by reversing the cuts within the upcoming omnibus appropriations laws. Many lawmakers are sounding the alarms proper alongside healthcare suppliers and affected person advocates. In a 2021 letter to CMS, 75 lawmakers within the Home of Representatives — led by Reps. Bobby Rush (D-In poor health.) and Gus Bilirakis (R-Fla.) — highlighted the troubling impacts that the cuts would have on the U.S. healthcare system.
Affected person entry to acceptable care, hard-earned progress towards well being fairness, and even our capability to battle the pandemic are in danger. There is just one moral plan of action: I respectfully encourage our representatives in Congress to behave to stop the weakening of our already strained healthcare system by offering aid for office-based specialty care and dealing on basic reform of the Doctor Charge Schedule.
Mark Garcia, MD, is CMO for American Vascular Associates and the Well being Coverage Advisor for United Specialists for Affected person Entry.

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