2....AMAdvocate - The AMA Physicians' Grassroots Network
Medicare Physician Payment Cuts Scheduled to go into effect Jan. 1, 2007
Congress is finally waking up to the seriousness of the drastic Medicare physician payment cuts scheduled to go into effect Jan. 1, 2007. The past weeks have seen a huge pushânewspaper ads, articles and editorials, thousands of e-mails and hundreds of physicians flying to Washington, D.C., for face-to-face meetingsâto urge Congress to take action to stop the mandated cuts.
But we still need you to weigh in. Many members of Congress said they still need to hear from physicians on this issue. Please call today. Because of the short time frame, phone calls will be the only way to get Congress to take action. Use the American Medical Association Grassroots Hotline at (800) 833-6354.
Urge Sen. Arlen Specter, Sen. Rick Santorum and Rep. Charles W. Dent ((or YOUR two U.S. Senators and Representative, if you don't live in Pennsylvania)) to take action to stop the mandated 5 percent cut and replace Medicareâs flawed payment formula with one that reflects increases in physician practice costs. For more talking points on the issue, please see our Physician Payment Action Kit.
A solution to this problem must be on their agenda now!
Together, we are stronger!
Call Congress Today!
(800) 833-6354
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For more information, please visit:
http://www.ama-assn.org/grassroots
http://www.ampaconline.org
3...From AMA EVoice
AMA eVoice® is a trademark of the American Medical Association
General AMA news
1) 265 U.S. representatives favor positive Medicare physician payment update
In a recent letter, 265 members of the House of Representatives urged their leaders to ensure Congress takes action before it adjourns to provide a positive update in Medicare physician payments for 2007. The letter explains how the projected cuts would destabilize the Medicare program and threaten patients' access to health care. A similar letter sent to Senate leadership in July garnered the signatures of 80 senators.
Patients are concerned about how these cuts will adversely affect access to health care for seniors. The 1.2 million-member AMA Patients' Action Network has generated more than 725,000 contacts to Congress to demand a halt to the cuts.
All physicians and medical students are urged to get in touch with their members of Congress, who are scheduled to adjourn Sept. 29. Tell them to take action before that to stop the 5.1 percent cut in Medicare physician payments for 2007 and provide a positive update that reflects practice costs, as recommended by the Medicare Payment Advisory Commission. Explain that if Congress doesn't act, the current system will reduce patients' access to care.
Visit the Web site or call (800) 833-6354 to be connected with your members of Congress.
4...from the AMA Alliance
Dear Members of the AMA Alliance,
The alert below, sent from our President, President-elect, and Chair of the Legislation Committee, contains important information on a critical issue effecting the family of medicine. Please read this letter from your AMA Alliance and act accordingly. Thank you!
* * * * * * * * * *
An Open Letter to the Members of the AMA Alliance
Monday, September 25, 2006
Dear Members of the AMA Alliance,
As leaders of the Alliance, we are sending this alert on what may be one of the most important weeks for the medical family. Today, we ask you to take an action and join us in the fight to preserve our spouses' right to practice medicine in these United States according to their professional judgment for all of their patients. It has never been more critical for our Alliance to unite in an effort to stop the government dictation of what medical services are worth and who can receive those services. If you have never had much interest in advocacy or thought of yourself as a political activist, we hope this plea will change your mind.
With only four days until Congress is scheduled to adjourn and return to the states to campaign for re-election, there has been no action to stop next year's 5.1 percent Medicare payment cut. The results of this action will be devastating to both physicians and to the health care system in your state. Your practice costs are expected to increase more than 20 percent over the next nine years, while Medicare is going to slash physician payments by almost 40 percent. The numbers don't add up and our spouses are working under a flawed payment formula.
What we are asking of you is very simple.
* First and foremost, always exercise your right to vote in every election. Changing some of the members of Congress may turn the attitude toward medicine in the right direction. But, for now we must work with who is in office.
* Take a moment of your day today, and contact your Senators and House members by phone, fax or e-mail. Simply go to
www.ama-assn.org/grassroots and compose a short e-mail to your Congressmen. Call the AMA's Grassroots Hotline at 800-833-6354 and you will be patched to your state officials. Urge them to take action and stop the mandated 5 percent cut this year and replace Medicare's flawed payment formula with one that reflects increases in physician costs.
How many times do we talk on the phone a day? Wouldn't you make a call to the police if you thought your family was in danger? The family of medicine is in danger and we all must pick up the phone and call for help! Do not let the sun set without taking action. Then, when your spouse returns from a long day taking care of patients, impress upon him/her the importance of sending an e-mail or finding time in his/her day tomorrow to do what you did today. Let's jam the Capitol with messages from the homes of the families that these cuts will hurt.
Isn't your family worth the effort?
Sincerely,
Nita Maddox, President
Dianne Fenyk, President-elect
Angela A. Ladner, Legislation Chairman
5.....ACS NewsScope
MEDICARE PAYMENT STALLED FOR NINE DAYS
A Weekly News Update from the American College of Surgeons
September 22, 2006
As reported earlier this summer, the Medicare program will not make any payments on claims from September 22 through September 30, the end of the federal government's fiscal year.
Payments that would have been made during that nine-day period will be made on October 2, the first business day of the new fiscal year. No interest will be paid on the delayed payments.
The Deficit Reduction Act, which repealed the 4.4 percent cut in the payment rate that went into effect January 1 of this year, requires this delay in payments. For more information, contact
[email protected]
6.....The Kansas City Star
Medicare cuts draw opposition: Doctors say a proposed 5.1 percent reduction in fees will hurt patient care
9/19/06
By Julius A. Karash
Sep. 19, 2006 (McClatchy-Tribune Business News delivered by Newstex) --
"The more you cut back, the more stress on the system." Kansas City oncologist Sukumar Ethirajan
A scheduled cut in Medicare payments is bringing out the fight in doctors.
Under a federal formula designed to control Medicare spending, the program's fees to doctors are scheduled to drop 5.1 percent next year, along with additional cuts in future years.
The plan has drawn vehement opposition from physicians in the Kansas City area and around the country.
"I know a number of physicians who love taking care of Medicare patients, but not at any cost," said anesthesiologist Robert Gibbons, president of the Metropolitan Medical Society of Greater Kansas City. "They'll not be able to absorb these cuts."
In a national poll of doctors earlier this year, the American Medical Association found that 45 percent of those surveyed said they will be forced to treat fewer Medicare patients or stop taking new Medicare patients if fee reductions go through.
Sukumar Ethirajan, a Kansas City oncologist and past president of the local medical society, said the cuts are coming as doctors contend with higher overhead costs for things such as electronic health records.
"The more you cut back, the more stress on the system," he said. "There is no incentive for an already stretched and spent physician to open up the practice to Medicare patients."
Hundreds of physicians from around the country were in Washington last week asking Congress to stop the expected string of cuts, which the AMA said will amount to nearly 40 percent in fee reductions in the next nine years.
"Unless Congress does something to avoid this, it's going to make me cut something out," said Larry Fields, a Kentucky family medicine doctor who is president of the Leawood-based American Academy of Family Physicians. "The most important thing is it affects access to quality care for patients."
Under federal law, Medicare physician payments are adjusted every year according to a formula based on actual spending and target spending.
In congressional testimony in July, Centers for Medicare & Medicaid Services administrator Mark McClellan described a frustrating struggle to control costs in the financially troubled Medicare program.
McClellan said Medicare spending on physician services has been exceeding targets. He noted that Congress had acted to stave off physician payment cuts in 2004, 2005 and 2006.
"There is already substantial evidence of overuse, misuse and underuse of medical treatments that results in potentially preventable complications and higher costs," McClellan said.
"Yet by paying more for more treatments, regardless of their quality or impact on patient health, our current system does little to address these quality problems and in certain respects could support and encourage less than optimal care."
But Cecil B. Wilson, board chairman of the AMA, said the danger to care lies in the scheduled fee cuts.
"Physicians will decide to retire early," said Wilson, an internal medicine doctor in Winter Park, Fla. "Young people trying to decide whether they want to be a physician will think they will do better in another profession."
Wilson said that the cuts will hit especially hard at primary care doctors, who receive relatively lower reimbursements already.
To make sure its voice is heard, the AMA last week announced a $1.5 million advertising campaign aimed at lawmakers and their constituents. The goal is to get Congress to reverse the fee cut before the midterm election.
Some observers think the doctors are overstating their case somewhat. Paul Ginsburg, president of the Washington-based Center for Studying Health System Change, said he didn't think a one-year, 5.1 percent cut would make it harder for Medicare patients to find a doctor.
"But I'm also convinced that a multiyear reduction, with cumulative large magnitude, certainly would have an impact that the policymakers would not want -- fewer physicians treating Medicare patients," Ginsburg said.
Rep. Bill Thomas, chairman of the House Ways and Means Committee, said last week that he may introduce a new version of a stalled tax bill that would include a provision to reverse the scheduled fee reduction, according to KaiserNetwork.org, a Web site of the Kaiser Family Foundation.
7....The Herald Times
Medicare cuts could be bad for patients
Five percent cut in payments means doctors may choose to limit number of Medicare patients they see
September 17, 2006
BLOOMINGTON -- If you're on Medicare, you may soon find it difficult persuading a physician to see you.
That's because Medicare payments to physicians are scheduled to be significantly cut starting Jan. 1, 2007.
The cuts of 5 percent in 2007, and 37 percent over the next nine years, will force some physicians to limit the number of Medicare patients they see.
A recent survey conducted by the American Medical Association found that 45 percent of the doctors who responded said they would either decrease or stop seeing new Medicare patients if next year's 5 percent cut goes through.
"It would be devastating to my practice," said Dr. James LaFollette, a Bloomington family practice physician for the past four decades. "Thirty to 40 percent of my patients are on Medicare, and 65 percent are over 50."
If the cuts are made according to what is called the Medicare sustainable growth rate formula, LaFollette predicts many doctors will stop accepting new Medicare patients -- and others will simply leave the profession.
"I'd probably just hang it up," he said. "It would simply be too much work for too little money. Even without these cuts, my income has been going down steadily for the past 10 years."
LaFollette said patients on Medicare usually require more tests than non-Medicare patients because they have multiple problems, such as heart disease, high blood pressure and arthritis.
He said shrinking Medicare payments, coupled with rising health-care costs, would force some doctors to shorten the turnaround time for seeing patients.
"I could never in good conscience do that," LaFollette said. "If you don't spend sufficient time talking to and listening to your patients, you will make mistakes in assessing and treating them."
Dave Burnworth, senior director of clinical operations at Internal Medicine Associates in Bloomington, said the projected cuts might force IMA to stop seeing new Medicare patients.
"The cuts would put us in a heck of a quandary," he said. "We wouldn't want to cut corners in terms of providing good medical care, but we couldn't take that big of a hit and not change the way we provide service."
Burnworth said IMA has always used income from paying patients to help cover the cost of treating those who can't pay.
"If Medicare cuts our physician payments that much, we would no longer be able to do that," he said. "But we'd hate to stop seeing new Medicare patients because aging patients tend to need the most care."
Costs rising, too
Making the scheduled cuts even harder to endure for physicians is the escalating cost of caring for patients, which the federal government estimates will increase 22 percent over the next nine years.
"In order to continue providing high-quality service we need to spend money on new technology and give raises to our staff to keep them here," Burnworth said. "That makes the proposed cuts even more damaging."
State perspective
Kevin Burke, president of the Indiana State Medical Association, said the physician payment reductions would seriously hinder Indiana's 850,000 Medicare patients' ability to get medical care.
"In addition, TRICARE, which provides health insurance for military families and retirees, ties its physician payment rates to Medicare," Burke said. "So the Medicare cuts could hurt access to care for Indiana's 82,000 TRICARE beneficiaries as well."
System in trouble
Burnworth and LaFollette feel the Medicare system, unless it's overhauled, is destined for an economic meltdown.
"It's deteriorating fast," LaFollette said. "And it looks as if it's only going to get worse in the years ahead."
Burnworth said, according to the U.S. Census Bureau, people between the ages of 65 and 84 will compose 16 percent of the country's population in 2050, compared with 11 percent in 2000.
During that same span, he said, the 20- to 44-year-olds will go from 37 to 31 percent of the U.S. population.
"That means there will be a shrinking financial base to support the Medicare system," he said. "These cuts are like Band-Aids, but the system is hemorrhaging."
Physician shortage?
The Council on Graduate Medical Education predicts a shortage of 85,000 physicians nationally by 2020, adding that "multi-year cuts in Medicare will likely exacerbate this shortage."
The American Medical Association said if the cuts go through, it might lead to a reduction in the number of Indiana's 61,000 doctors, technicians and support staff.
"Seniors in Indiana can't afford to lose their doctors," Burke said. "With just 16 practicing physicians per 1,000 Medicare beneficiaries in 2005, Indiana is already well below the national average of 20 physicians per 1,000 Medicare patients."
LaFollette said the Medicare cuts would be most devastating to primary care doctors, who he said are already "low man on the totem pole."
"Some have predicted that eventually there will be no more primary care doctors," LaFollette said. "They may be replaced by nurse practitioners and clinics like Promptcare."
Political pressure
The AMA and Indiana State Medical Association are urging Medicare patients to ask Indiana's congressional delegates to stop the looming cuts.
"In Indiana Medicare reimbursements will be cut $62 million next year and $4 billion over the next nine years," Burke said. "That's a huge loss of federal dollars, which creates a major barrier to seniors' access to care."
In August, 80 U.S. Senators, including Indiana Sens. Evan Bayh and Richard Lugar, sent a letter to the Senate leadership urging Congress to act soon to stop the impending cuts.
"Sen. Bayh believes that addressing the planned cuts for Medicare services should be a priority for Congress," said Meghan Keck, Bayh's press secretary. "If the Medicare cuts go into effect, they could impact thousands of Medicare patients whose doctors are forced to cut back on services as a result. Sen. Bayh will continue working to encourage a resolution to this issue."
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