New Physician Fee Schedule

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SoulinNeed

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I should add that this is not final, and just a proposal, and the final schedule will be released in a few months.

http://www.ofr.gov/OFRUpload/OFRData/2013-16547_PI.pdf

Check page 540. I don't know if I'm reading it correctly, but a few specialties are getting modest increases (though, Anesthesiology and EM will be getting a 3% increase). Others, mainly pathology and radiation ocology are taking major hits (5% each). RO had a 7% reduction last year. There also a number of other services that this chart includes. Independent laboratory testing is taking a massive 26% reduction.

In other news, hospital outpatient services are going up 1.8%, inpatient services 2.5%, and Ambulatory surgery 0.9%. Of course, I should add that CMS is implementing more bundled payments, and they are instituting more quality care measurements that need to be met to avoid payment penalties.

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I should add that this is not final, and just a proposal, and the final schedule will be released in a few months.

http://www.ofr.gov/OFRUpload/OFRData/2013-16547_PI.pdf

Check page 540. I don't know if I'm reading it correctly, but a few specialties are getting modest increases (though, Anesthesiology will be getting a 3% increase). Others, mainly pathology and radiation ocology are taking major hits (5% each). RO had a 7% reduction last year. There also a number of other services that this chart includes. Independent laboratory testing is taking a massive 26% reduction.

In other news, hospital outpatient services are going up 1.8%, inpatient services 2.5%, and Ambulatory surgery 0.9%. Of course, I should add that CMS is implementing more bundled payments, and they are instituting more quality care measurements that need to be met to avoid payment penalties.

I need a sparknotes of this.
 
What's so bad about independent labs that the govt. is hitting them so hard?
 
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I should add that this is not final, and just a proposal, and the final schedule will be released in a few months.

http://www.ofr.gov/OFRUpload/OFRData/2013-16547_PI.pdf

Check page 540. I don't know if I'm reading it correctly, but a few specialties are getting modest increases (though, Anesthesiology will be getting a 3% increase). Others, mainly pathology and radiation ocology are taking major hits (5% each). RO had a 7% reduction last year. There also a number of other services that this chart includes. Independent laboratory testing is taking a massive 26% reduction.

In other news, hospital outpatient services are going up 1.8%, inpatient services 2.5%, and Ambulatory surgery 0.9%. Of course, I should add that CMS is implementing more bundled payments, and they are instituting more quality care measurements that need to be met to avoid payment penalties.

It's hard to glean much because it's a proposal.
 
a lot of sketchy behavior basically

That's the stereotype/general belief. However, there are aspects of hospital based care that inflate medical costs as well.

I imagine that a major issue is that stand-alone practices don't have to deal with the uninsured, while major hospitals dont have that luxury.

That, at least, is the reason why a hospital's prices for routine procedures is higher than it is at stand-alone centers, as they have to offset the cost of providing care to the uninsured who aren't going to be pay their medical bills.
 
Keep in mind CPI (rough inflation proxy) increase was ~2.1% Y-o-Y. New 2013 CPI data should be out in a few days.

So the real fee increase is actually minimal for your stated "modest increases."

Out of curiosity, when was this proposed fee schedule first released? I opened the pdf, but saw it was 600+ pages and quickly aborted lol.
 
Keep in mind CPI (rough inflation proxy) increase was ~2.1% Y-o-Y. New 2013 CPI data should be out in a few days.

So the real fee increase is actually minimal for your stated "modest increases."

Out of curiosity, when was this proposed fee schedule first released? I opened the pdf, but saw it was 600+ pages and quickly aborted lol.
Monday, and yeah, it may not be keeping up with inflation, but few things are. At this point, an increase is something to be happy about.
 
Monday, and yeah, it may not be keeping up with inflation, but few things are. At this point, an increase is something to be happy about.

Interesting. Now I know why DGX took a hit at Tuesday open. :(
 
That's the stereotype/general belief. However, there are aspects of hospital based care that inflate medical costs as well.

I imagine that a major issue is that stand-alone practices don't have to deal with the uninsured, while major hospitals dont have that luxury.

That, at least, is the reason why a hospital's prices for routine procedures is higher than it is at stand-alone centers, as they have to offset the cost of providing care to the uninsured who aren't going to be pay their medical bills.

Facility fees are bull****, and are entirely the reason physicians are going from private practice to employed. It is just a handout to hospitals probably lobbied by the AHA. If the fees only applied to inpatient care it would be different, but they apply to everything (including outpatient facilities off-site) owned by the hospital.
 
That's the stereotype/general belief. However, there are aspects of hospital based care that inflate medical costs as well.

I imagine that a major issue is that stand-alone practices don't have to deal with the uninsured, while major hospitals dont have that luxury.

That, at least, is the reason why a hospital's prices for routine procedures is higher than it is at stand-alone centers, as they have to offset the cost of providing care to the uninsured who aren't going to be pay their medical bills.

He meant that the AHA lobbyists pretty much run the show. Driving independent practices out of business means less competition for local hospitals, and consequently more $$$.
 
He meant that the AHA lobbyists pretty much run the show. Driving independent practices out of business means less competition for local hospitals, and consequently more $$$.

I thought he meant that independent doctors offices and physician run centers did a bunch of sketchy things. Guess I misunderstood. Yeah, the AHA is apparently pretty damn powerful for the facility fee to be as expensive (almost equal to the cost of the service... insane) as it is.
 
Hospitals have basically said that if you want to do procedures there, you have to sell your practice to them and become an employee of the hospital. If not, they price you out of doing work there with your patients. Exactly this happened with several cardiologists I know.

Check into the Medicare RVU schedule to see what trends in reimbursements are doing, there is generally a few year lag, but the fields that get cut the most end up being less competitive in the future.
 
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