New CMS fee schedule cuts Rad Onc (-14%) and Rads (-4%) payments

[KinasePro]

The final fee schedule won't be out until November, but you can see the current proposal in full here. See pages 680-681. A short summary of the cuts is here.

Increases in reimbursement are slated for primary care specialties (4-7%), obstetrics/gynecology (1%), ophthalmology (1%), and nurse practitioners (5%).

EDIT: There's a thread on the Rad Onc forums about these cuts, looks like there's some minor debate as to how much they would effect their bottom line.

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[Slack3r]

Lol

 

[Shnurek]

Woo optometry going up 1% too

 

[VisionaryTics]

Woo optometry going up 1% too

Outpaced by inflation.

 

[Shnurek]

Outpaced by inflation.

Yes, no doubt. http://bottomline.msnbc.msn.com/_ne...-canadians-are-now-richer-than-americans?lite

Sorry guys America's golden age is over because of increased socialist policies and governmental burden.

 

[Frazier]

Ouch for RadOnc... in addition to the -14% for the specialty, further down the table it also says:

"RADIATION THERAPY CENTERS: -19%"

Looks like there is going to be a big dent in those astronomical PP partner salaries.

...and down comes that high Step 1 mean!

[However, they did dodge a -20% proposed reduction in 2009, IIRC. So we'll see how it unfolds.]

 

[KinasePro]

Ouch for RadOnc... in addition to the -14% for the specialty, further down the table it also says:

"RADIATION THERAPY CENTERS: -19%"

Looks like there is going to be a big dent in those astronomical PP partner salaries.

...and down comes that Step 1 mean!

My thoughts exactly. If these changes go into effect, I can imagine the ~40 hr wk/ no nights/ no weekends lifestyle becoming a thing of the past.

There's more bad news for radiologists, too: DIAGNOSTIC TESTING FACILITY: -8%

I also found it interesting that ortho wasn't hit very hard. There's a lot of talk of the CMS hammer coming down on orthopods in the near future, lucky for them it won't be happening this year.

 

[calvnandhobbs68]

The final fee schedule won't be out until November, but you can see the current proposal in full here. See pages 680-681. A short summary of the cuts is here.

Increases in reimbursement are slated for primary care specialties (4-7%), obstetrics/gynecology (1%), ophthalmology (1%), and nurse practitioners (5%).

You know what's a great way to bring those costs down that NPs are always talking about? Increase their reimbursements

Edit: Wow audiologists (-5%) and CSWs (-3%) kind of gettin boned too. It's not like social workers make that much money already wonder where that came from...

 

[Marcus Brody]

The final fee schedule won't be out until November, but you can see the current proposal in full here. See pages 680-681. A short summary of the cuts is here.

Increases in reimbursement are slated for primary care specialties (4-7%), obstetrics/gynecology (1%), ophthalmology (1%), and nurse practitioners (5%).

 

[Slack3r]

Interestingly, the thread about the cuts in the Rad Onc forums seems to be pretty apathetic about it, if not actually agreeing that the procedural codes in question are overvalued.

 

[Frazier]

Interestingly, the thread about the cuts in the Rad Onc forums seems to be pretty apathetic about it, if not actually agreeing that the procedural codes in question are overvalued.

+1

I headed over to their subforum to see if I could catch a show after reading this thread... needless to say, it was an anticlimactic letdown.

 

[Jay Gatsby]

Ouch for RadOnc... in addition to the -14% for the specialty, further down the table it also says:

"RADIATION THERAPY CENTERS: -19%"

Looks like there is going to be a big dent in those astronomical PP partner salaries.

...and down comes that high Step 1 mean!

[However, they did dodge a -20% proposed reduction in 2009, IIRC. So we'll see how it unfolds.]

Med students will suddenly realize they have lost that passion for RadOnc

 

[Jay Gatsby]

Seriously. Wtf? Social workers should be the last people getting any cuts in reimbursement. And does the NP increase in reimbursement refer to only NPs in primary care fields or for all NPs in general? No reason why derm NPs need an increase in reimbursement.

These reimbursement cuts are getting ridiculous. They would make sense if physician incomes made up a large part of health care costs, but don't current estimates only place them at around 6.5-8%? Man, we really need a better lobby that looks out for physician interests overall instead of just fractured, specialty-specific PACs (which aren't that effective in most fields, it seems like)...

If only, old sport.

 

[KinasePro]

I think the non-chalant reactions to bad news like this are pretty typical in our profession though... If you go to the radiology or anesthesiology forums, in each of the threads complaining about CRNAs/ job outlook/reimbursements there's a pack of attendings/residents enthusiastically defending their fields. I think it's a mix of a) legitimate pride & contentment in their specialties, b) downplaying the negatives of their specialties to maintain a rosy worldview, and c) the reality of the incremental pay cuts and crappy job markets not being a huge deal when all things are considered.

So i wouldn't really expect people to get too riled up about incremental medicare cuts, but over time this is how change occurs in a specialty. One change after another, year after year, and the next thing you know RadOnc will be using SOAP to fill empty slots in the match (which happened to rads this year, actually).

 

[Slack3r]

It doesn't help that medicine is basically a few dozen different lobbies all advocating that you cut the other guy. FM is getting a boost to the detriment of imaging service, yet they couldn't be happier. CRNAs can now be reimbursed at equal levels of board certified pain doctors, yet I don't see many dermatologists up in arms about that. It's about time that the AMA or some other organization began actually looking out for the interest of physicians, yet I doubt it happens.

 

[justaregularmed]

These cuts are appropriate and its only physicians fault. I would loosely call them "greed" cuts. You notice they are mostly in procedural based medical specialties whom have taken it upon themselves to have an invention very streamlined, happends to be popular and reimburses well. I.E. quick procedures for high reimbursement are getting hit, this makes sense.

There are a few paradoxical ones like nephrology unless this is somehow compensating by the more dialysis patients or something. I'm impressed GI didn't get hit. Heme onc should have been hit worse, I understand why psych got hit.

The key here is diversity or be a surgeon, otherwise they are going to whittle you down.

 

[Frazier]

These cuts are appropriate and its only physicians fault. I would loosely call them "greed" cuts. You notice they are mostly in procedural based medical specialties whom have taken it upon themselves to have an invention very streamlined, happends to be popular and reimburses well. I.E. quick procedures for high reimbursement are getting hit, this makes sense.

There are a few paradoxical ones like nephrology unless this is somehow compensating by the more dialysis patients or something. I'm impressed GI didn't get hit. Heme onc should have been hit worse, I understand why psych got hit.

The key here is diversity or be a surgeon, otherwise they are going to whittle you down.

Surgery isnt exempt from taking significant hits. Spine was on cloud 9 with their reimbursements, simple change comes and now look: significant change.

Only so many hours in a day to perform surgery, if your codes are changed: SOL.