Flow cytometry compensation slashed by 70%

[LADoc00]

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For all those people interested in going into Hemepath, as of the first of the year, flow cytometry compensation from medicare will drop over 70%.

This is a economic disaster for hemepath where you made up for the fact that bone marrow exams tooks far longer than smaller specimens by doing less and making more money on the flow. I would go so far as to say this will destroy hemepath as field in pathology and Im not alone in this. This year hemepath jobs were plentiful but I doubt that trend will continue for very long.

To put this in perspective, if you did primarily hemepath and you made $200,000 this year, next year you will make $80,000-100,000 working just as hard.

Aint democracy grand? A pencil-pusher can destroy an entire subspeciality with a single document he probably spent 30 min drafting.

 

[SpinachPizza]

What/where is your source for this news, specifically?

 

[LADoc00]

USCAP, ASCP and ASH. ASH was last week and people were decompensating at the news. Would be amusing if I wasnt getting jacked myself. 😡

 

[pathdawg]

For all those people interested in going into Hemepath, as of the first of the year, flow cytometry compensation from medicare will drop over 70%.

This is a economic disaster for hemepath where you made up for the fact that bone marrow exams tooks far longer than smaller specimens by doing less and making more money on the flow. I would go so far as to say this will destroy hemepath as field in pathology and Im not alone in this. This year hemepath jobs were plentiful but I doubt that trend will continue for very long.

To put this in perspective, if you did primarily hemepath and you made $200,000 this year, next year you will make $80,000-100,000 working just as hard.

Aint democracy grand? A pencil-pusher can destroy an entire subspeciality with a single document he probably spent 30 min drafting.

This is indeed bad news, but I can't see a hemepath person only making 100K/yr. Will this have a negative impact on the field? Yes. Will it completely destroy it? Unlikely. I know people often react to these things as if the sky were falling, but down the road, it won't be as devastating as people are describing.
I do agree that this may impact the hemepath job market. We'll see. Makes me kinda glad I chose cyto (we've been getting hosed over the whole pap smear reimbursement thing for years).

 

[LADoc00]

This is indeed bad news, but I can't see a hemepath person only making 100K/yr. Will this have a negative impact on the field? Yes. Will it completely destroy it? Unlikely. I know people often react to these things as if the sky were falling, but down the road, it won't be as devastating as people are describing.
I do agree that this may impact the hemepath job market. We'll see. Makes me kinda glad I chose cyto (we've been getting hosed over the whole pap smear reimbursement thing for years).

It will absolutely destroy companies like US LABS and Esoterix that depend hugely on flow reimbursements. Those companies employ dozens of hematopathologists who being fired will flood the job market with years of experience, making it very difficult for new fellows to find a job. I talked to one dept chair yesterday who said "If this stands in the court, it will be devastating."

I would say this is one of the worst turn of events in path within the last 10 years or so. Asking around, that seems to be consensus.

 

[RyMcQ]

I have seen the numbers. Instead of about 90 bucks per antibody (technical and professional fees), the reimbursement is ~$20/antibody (technical) plus $60-100/case (professional). Thus, a case with 16 antibodes that normally would generate ~$1400 only produces $420. It's harsh and may prevent me from being able to set up a flow lab at my new job. I do think that pathologists were abusing the former pricing structure by adding antibodies that aren't really that useful and don't add time to the interpretation, but increase revenue. Having a flat fee for the interp isn't a bad idea, but apparently the technical fees aren't going to cover expenses. Hopefully, our professional groups will be able to successfully lobby for changes soon. (I'm not holding my breath.)

 

[LADoc00]

I have seen the numbers. Instead of about 90 bucks per antibody (technical and professional fees), the reimbursement is ~$20/antibody (technical) plus $60-100/case (professional). Thus, a case with 16 antibodes that normally would generate ~$1400 only produces $420. It's harsh and may prevent me from being able to set up a flow lab at my new job. I do think that pathologists were abusing the former pricing structure by adding antibodies that aren't really that useful and don't add time to the interpretation, but increase revenue. Having a flat fee for the interp isn't a bad idea, but apparently the technical fees aren't going to cover expenses. Hopefully, our professional groups will be able to successfully lobby for changes soon. (I'm not holding my breath.)

Absolutely correct. The biggest thing: The reimbursement doesnt even COVER THE COST. F'ing government! Meaning, if you were doing solely heme in your group before, byebye time. I thank Jesus I have a written contract for next year already, I talked to one person who already had an interview offer retracted over this.

 

[yaah]

Now now, the government has its spending priorities. We have to give aid to all these countries so that they can continue to hate us. Oh, and we have to fund the perverted arts (Simpsons reference).

Perhaps pathologists will just not offer flow anymore? That might be the best way to make the point. I don't know how that would work though.

Figures something like this would get pushed through in a giant budget bill. Damn lawyers.

 

[1Path]

It must be me, but I think 100k is pretty good money compared to other professions. And this is coming from a person who's s mother is going to retire from NURSING at almost 100K.

 

[LADoc00]

It must be me, but I think 100k is pretty good money compared to other professions. And this is coming from a person who's s mother is going to retire from NURSING at almost 100K.

I sat down at Starbucks last year and began a conversation with a 22-year old who was selling health/life insurance to the elderly. He drove a Boxster. At 22 made 150K/year. So yes 25 years ago, 100K was something, it aint crap now. I would seriously rather collect unemployment and sit at home playing computer games than make 100K working in Pathology 12 hrs/day.

Read: Earth to the U.S. Government, Stopping Wasting my F'ing Time!

 

[yaah]

Read: Earth to the U.S. Government, Stopping Wasting my F'ing Time!

I don't mind so much that they waste my time, I just want them to stop wasting my F'ing money. Right now they are authorizing billions for a lip service adjustment to our national intelligence capabilities.

 

[pathdawg]

I sat down at Starbucks last year and began a conversation with a 22-year old who was selling health/life insurance to the elderly. He drove a Boxster. At 22 made 150K/year. So yes 25 years ago, 100K was something, it aint crap now. I would seriously rather collect unemployment and sit at home playing computer games than make 100K working in Pathology 12 hrs/day.

Read: Earth to the U.S. Government, Stopping Wasting my F'ing Time!

I would agree that 100K is not significant money, especially when you consider what we have invested in our careers (in terms of time and money). But LADoc, if you're working 12hrs/day in path, it may be time to look for another gig. I mean hell, if I wanted to work 12 hr days, I would have stayed in Internal Med.

 

[LADoc00]

I would agree that 100K is not significant money, especially when you consider what we have invested in our careers (in terms of time and money). But LADoc, if you're working 12hrs/day in path, it may be time to look for another gig. I mean hell, if I wanted to work 12 hr days, I would have stayed in Internal Med.

Two words bro: FROZEN SECTIONS
you leave when the OR is done.

 

[pathdawg]

Two words bro: FROZEN SECTIONS
you leave when the OR is done.

Thats one of the inherent problems with path: We are at the mercy of insane surgeons. I mean, who needs to do surgery at 7pm anyway. WTF. I wouldn't want my surgery to take place after 5pm when the surgeon, nurses, and (most importantly) pathologists are dog tired.

 

[RyMcQ]

Thats one of the inherent problems with path: We are at the mercy of insane surgeons. I mean, who needs to do surgery at 7pm anyway. WTF. I wouldn't want my surgery to take place after 5pm when the surgeon, nurses, and (most importantly) pathologists are dog tired.

At one of the community hospitals in SLC, there was a surgeon who would routinely start Whipples at 5pm. And he did the anastomoses by hand, so surgery would go until 2 or 3 am. He did this in part because he was manic and because he didn't get to this hospital until late afternoon after he had done surgeries all day elsewhere. But most of all, he acknowledged that he liked having pathology and radiology all to himself. Nobody had the guts to stand up to him because he brought in so much money, both for the department of pathology and the hospital. I rotated with him as a third year med student and he expected us to stay for the Whipple post call! I eventually got the nerve to tell him no way.

Anyway, when I was looking for a job, I didn't feel bashful asking how call usually went. I'll have some late nights, but it will be every third night and every third weekend at most.

 

[tsj]

For all those people interested in going into Hemepath, as of the first of the year, flow cytometry compensation from medicare will drop over 70%.

This is a economic disaster for hemepath where you made up for the fact that bone marrow exams tooks far longer than smaller specimens by doing less and making more money on the flow. I would go so far as to say this will destroy hemepath as field in pathology and Im not alone in this. This year hemepath jobs were plentiful but I doubt that trend will continue for very long.

To put this in perspective, if you did primarily hemepath and you made $200,000 this year, next year you will make $80,000-100,000 working just as hard.

Aint democracy grand? A pencil-pusher can destroy an entire subspeciality with a single document he probably spent 30 min drafting.

Is the cut for the laboratory or the professional reading of the results? I read that medicare increased professional fees 4% last year and that they will go up 1.5% next year. Medicare more or less dictates everything, as the insurance companies typically follow their lead.

 

[1Path]

As for the hours of operation of a typical pathologist, in the 2 years I've worked for, with and around pathologists at all levels of training I've yet to hear of one person complain about the hours. However, this is the NIH. Sounds like you guys are referring to private pathologists to which I say why in the world would someone want to be a pathologist in private practice other than for the 300K? Thanks but no thanks, I'll take the low 100's the goivernment/academic physicians are earning anyday. Private practice looks like a HUGE pain in the arse!

 

[RyMcQ]

Is the cut for the laboratory or the professional reading of the results? I read that medicare increased professional fees 4% last year and that they will go up 1.5% next year.

It's both. See the pricing scheme in my post above.

 

[LADoc00]

It's both. See the pricing scheme in my post above.

I was slotted to bring a flow lab online, Fooking A!, it was all the whole reason I was hired....But now WTH do I do? Sit around and wait to ****canned? Or write off all my heme training and subspecialize in uropath/bone/soft tissue? Im actually considering just picking up radiology on the fly and undercutting rads people in my area. At even 50% discounted rate from them, I would be making out like a bandito!

 

[1Path]

Changing subject here a little, I over heard a group of paths talking yesterday about the fact the in some areas of the US, Paths are NOT doing FNA's because of reinbursement issues. I think they said that the reinbursement is better/different/exists when an endocrinologist or surgeon does the procedure but not when path does it. Well I've had an FNA and the thought of having this done by anyone other than a path never crosses my mind and that was years BEFORE I became obsessed with the field!

What IS the medical world coming to!?!?!

 

[tsj]

I know you are just joking around, but as far as what rads gets, isn't it all based on medicare compensation? (except for cosmetic out of pocket stuff).

I was under the impression that it doesn't matter what rads or pathologists or anyone else charges, medicare pays what the pay and the insurance companies are typically within 10% on either side of it.