Hardest hit specialties from CMS cuts to Specialists

[MetroPath]

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Went to a conference this weekend: one slide was as follows:

Hardest hit specialties due to shift of reimbursement payments to primary care:

Pathology-8%
Ophthalmology-10%
Cardiac surgery-8%
Radiology-8%
Anesthesiology-7%

The ROAD specialties except Derm lol. Wonder why they go after Path?

 

[SunBakedTrash]

There’s a lesson in all this: Avoid hospital based specialties!

 

[Med Director New England]

A number of pathology codes have been flagged for abuse by the CMS over the years and there was a fair amount of abuse happening. 10-20 yrs ago there were a lot of codes over reimbursed imo. Multicolor Flow cytometry, ISH to name a couple.

No wonder there was scrutiny and adjustments. Medicare reimbursement is not the problem - for the most part Medicare pays at a reasonable rate. Payers pushing for sub-Medicare rates and pathologists being in no position to stop it because of market dynamics is a problem

 

[deleted941485]

A number of pathology codes have been flagged for abuse by the CMS over the years and there was a fair amount of abuse happening. 10-20 yrs ago there were a lot of codes over reimbursed imo. Multicolor Flow cytometry, ISH to name a couple.

No wonder there was scrutiny and adjustments. Medicare reimbursement is not the problem - for the most part Medicare pays at a reasonable rate. Payers pushing for sub-Medicare rates and pathologists being in no position to stop it because of market dynamics is a problem

THe question of Medicare making “fair” reimbursement is highly specialty dependent. My guess is things in path have gotten so bad on the private side that Medicare actually looks good or “fair” by comparison. Primary care is probably similar as many private carriers attempt to get sub Medicare rates for their population.

Anesthesia is one where most would consider the rates fair even before Medicare decided to shunt money from those evil rich specialists over to the poor souls in primary care.

 

[Med Director New England]

THe question of Medicare making “fair” reimbursement is highly specialty dependent. My guess is things in path have gotten so bad on the private side that Medicare actually looks good or “fair” by comparison. Primary care is probably similar as many private carriers attempt to get sub Medicare rates for their population.

Anesthesia is one where most would consider the rates fair even before Medicare decided to shunt money from those evil rich specialists over to the poor souls in primary care.

Fair enough. I am only speaking to path codes. No idea about other subspecialities.

 

[LADoc00]

Hospital based specialists will completely implode once they bundle payments from CMS for everything. Im thinking 7-8 years but could be sooner if Sanders/Warren win 2020. Much sooner.