lfesiam

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Anesthesiology got a medicare raise, 6% - the same as Internal Medicine, whoo hoooo! About time. newly matched MS4, contribute to your ASA and ASAPAC :)

Highest cuts - Radiology -11%, Rad Onc -19%.

Article by digitaldocMD

2010: Specialist Salary Cuts & Primary Care Pay Raise?

This had to happen some day...Medicare recently proposed readjustments in their payment amounts and here are numbers that reflect an approximate effect on payment to different physician specialties. Biggest losers seem to be Cardiology and Radiology. While Primary care (Internal medicine, Family Medicine, Geriatrics) would see higher payments...

SPECIALTY OVERALL PAYMENT CHANGES
1 ALLERGY/IMMUNOLOGY -3%
2 Blank
3 ANESTHESIOLOGY 6%
4 CARDIAC SURGERY -2%
5 CARDIOLOGY -11%
6 COLON AND RECTAL SURGERY 5%
7 CRITICAL CARE 3%
8 DERMATOLOGY 3%
9 EMERGENCY MEDICINE 2%
10 ENDOCRINOLOGY 3%
11 FAMILY PRACTICE 8%
12 GASTROENTEROLOGY 0%
13 GENERAL PRACTICE 6%
14 GENERAL SURGERY 4%
15 GERIATRICS 8%
16 HAND SURGERY 3%
17 HEMATOLOGY/ONCOLOGY -6%
18 INFECTIOUS DISEASE 3%
19 INTERNAL MEDICINE 6%
20 INTERVENTIONAL PAIN MGT. 6%
21 INTERVENTiONAL RADIOLOGY -10%
22 NEPHROLOGY 2%
23 NEUROLOGY 3%
24 NEUROSURGERY 2%
25 NUCLEAR MEDICINE -13%
26 OBSTETRICS/GYNECOLOGY 1%
27 OPHTHALMOLOGY 11%
28 ORTHOPEDIC SURGERY 3%
29 OTOLARNGOLOGY 1%
30 PATHOLOGY 0%
31 PEDIATRICS 4%
32 PHYSICAL MEDICINE 7%
33 PLASTIC SURGERY 5%
34 PSYCHIATRY 3%
35 PULMONARY DISEASE 3%
36 RADIATION ONCOLOGY -19%
37 RADIOLOGY -11%
38 RHEUMATOLOGY -1%
39 THORACIC SURGERY 2%
40 UROLOGY -7%
41 VASCULAR SURGERY -1%
42 AUDIOLOGIST -10%
43 CHIROPRACTOR 5%
44 CLINICAL PSYCHOLOGIST -7%
45 CLINICAL SOCIAL WORKER -6%
46 NURSE ANESTHETIST 2%
47 NURSE PRACTITIONER 7%

Other Healthcare Workers

48 OPTOMETRY 12%
49 ORAL/MAXILLOFACIAL SURG 1%
50 PT/OT 10%
51 PHYSICIAN ASSISTANT 5%
52 PODIATRY 6%

Source: Medicare Program: Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2010.

The big cuts for Cardiology and Radiology comes due to cuts to the money paid per procedure - for example, Medicare plans to pay 38% less per stress test, 31% Less per cardiac Stent and 32% less per Left Heart Catherterization.

Cardiologists are obviously not happy about this. "Robbing subspecialist Peter to pay general practitioner Paul is a dangerous proposal for our patients. Instead of devaluing subspecialist services in order to find the revenue, why not implement some simple new practices for our country that will yield huge payoffs immediately?", Says Cardiologist Dr Melissa Walton-Shirley, also the owner of TheHeart.org

I am not sure if this might bring down the number of procedures, in fact the there might be a temptation to perform more of them to make up for the lost income ! What the American Health System needs is an uncoupling of payments from procedure volume.

Source: DigitaldocMD
 
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bigeyedfish

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The problem is how low it is to begin with. $17/unit + 6% still only equals $18/unit. Far from PP $50-60/unit
 

Gimlet

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This is encouraging! I've definitely wondered why anesthesiology was so under-reimbursed in Medicare.
A step in the right direction, but 6% is barely a drop in the bucket when you consider anesthesiology's "33% problem."

I thought #46 on lfesiam's list was interesting...also:

digitaldocMD said:
What the American Health System needs is an uncoupling of payments from procedure volume.
I'm pretty sure that's a good way to make people wait months to get a left heart cath.

Edit: Big-eyed fish beat me to it.
 

RussianJoo

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Do you mind posting a link to this I want to show these numbers to an attending friend but he'll want to see an actual source..

also it's funny that I found this article... I guess Rad-Onc people spoke too soon about healthcare reform considering they were one of the bigger loser in the above mentioned data. http://www.medicalnewstoday.com/articles/183472.php
 

Stank811

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Below is a brief insight into the political game surrounding the big bad proposed Medicare Cut...it has been going on for decades and will continue to go on


Back in 1997 the Congress had a decent enough idea. They wanted to restrict the growth of payments to Medicare doctors. Health inflation started to skyrocket in later years, far beyond regular inflation. So every year, Congress put a patch on this restriction, called the sustainable growth rate (SGR). People knew that Congress wouldn’t restrict the payments, but it became this “surprise” to the budget every single year.

The Obama Administration wanted to do away with the gimmick, and saw health care reform as an opportunity to do that, and admit the reality that Congress will never cut these payments. But Republicans saw a political opportunity. They could claim that Congress took the budget hit for health care reform “off the books,” when in fact they were just admitting that the real budgetary cost of Medicare is higher than what is typically acknowledged. So when it came up for a vote today it was sufficiently demagogued enough that it only mustered 47 votes, with fiscal scolds puffing out their chests and claiming that such an expense has to be “offset.” Even Steny Hoyer got in on that act, demanding that a doctor’s fix must be tied to adopting pay-go rules.

Never mind the fact that a one-year fix will pass with almost unanimous support. And all of these politicians will run back to their districts and tell people that they saved doctor’s livelihoods and hospitals and access to health care. It’s basically just a game.

But this is playing out in the middle of the health care debate. And it’s making the Democratic leadership look awful. Harry Reid is claiming that the AMA promised Republican votes for the fix, and he was led astray. The very notion of deals with the AMA to fatten the pockets of their Medicare doctors in exchange for health care support is unseemly. And nobody looks like they know how to count, in addition to the fact that they are relying on Republicans to be interested in governance rather than winning the day-to-day political battle.
 

sevo85288

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why do people keep spreading mis information? The unit rate unadjusted for 2009 was $21.34. Assuming the SGR cut is stopped and the 6% is added that would be $21.34 plus 1.28 = 22.60. It is NOT $17/unit.
 

gasaddict54

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Anesthesiology got a medicare raise, 6% - the same as Internal Medicine, whoo hoooo! About time. newly matched MS4, contribute to your ASA and ASAPAC :)

Highest cuts - Radiology -11%, Rad Onc -19%.

Article by digitaldocMD

2010: Specialist Salary Cuts & Primary Care Pay Raise?

This had to happen some day...Medicare recently proposed readjustments in their payment amounts and here are numbers that reflect an approximate effect on payment to different physician specialties. Biggest losers seem to be Cardiology and Radiology. While Primary care (Internal medicine, Family Medicine, Geriatrics) would see higher payments...

SPECIALTY OVERALL PAYMENT CHANGES
1 ALLERGY/IMMUNOLOGY -3%
2 Blank
3 ANESTHESIOLOGY 6%
4 CARDIAC SURGERY -2%
5 CARDIOLOGY -11%
6 COLON AND RECTAL SURGERY 5%
7 CRITICAL CARE 3%
8 DERMATOLOGY 3%
9 EMERGENCY MEDICINE 2%
10 ENDOCRINOLOGY 3%
11 FAMILY PRACTICE 8%
12 GASTROENTEROLOGY 0%
13 GENERAL PRACTICE 6%
14 GENERAL SURGERY 4%
15 GERIATRICS 8%
16 HAND SURGERY 3%
17 HEMATOLOGY/ONCOLOGY -6%
18 INFECTIOUS DISEASE 3%
19 INTERNAL MEDICINE 6%
20 INTERVENTIONAL PAIN MGT. 6%
21 INTERVENTiONAL RADIOLOGY -10%
22 NEPHROLOGY 2%
23 NEUROLOGY 3%
24 NEUROSURGERY 2%
25 NUCLEAR MEDICINE -13%
26 OBSTETRICS/GYNECOLOGY 1%
27 OPHTHALMOLOGY 11%
28 ORTHOPEDIC SURGERY 3%
29 OTOLARNGOLOGY 1%
30 PATHOLOGY 0%
31 PEDIATRICS 4%
32 PHYSICAL MEDICINE 7%
33 PLASTIC SURGERY 5%
34 PSYCHIATRY 3%
35 PULMONARY DISEASE 3%
36 RADIATION ONCOLOGY -19%
37 RADIOLOGY -11%
38 RHEUMATOLOGY -1%
39 THORACIC SURGERY 2%
40 UROLOGY -7%
41 VASCULAR SURGERY -1%
42 AUDIOLOGIST -10%
43 CHIROPRACTOR 5%
44 CLINICAL PSYCHOLOGIST -7%
45 CLINICAL SOCIAL WORKER -6%
46 NURSE ANESTHETIST 2%
47 NURSE PRACTITIONER 7%

Other Healthcare Workers

48 OPTOMETRY 12%
49 ORAL/MAXILLOFACIAL SURG 1%
50 PT/OT 10%
51 PHYSICIAN ASSISTANT 5%
52 PODIATRY 6%

Source: Medicare Program: Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2010.

The big cuts for Cardiology and Radiology comes due to cuts to the money paid per procedure - for example, Medicare plans to pay 38% less per stress test, 31% Less per cardiac Stent and 32% less per Left Heart Catherterization.

Cardiologists are obviously not happy about this. "Robbing subspecialist Peter to pay general practitioner Paul is a dangerous proposal for our patients. Instead of devaluing subspecialist services in order to find the revenue, why not implement some simple new practices for our country that will yield huge payoffs immediately?", Says Cardiologist Dr Melissa Walton-Shirley, also the owner of TheHeart.org

I am not sure if this might bring down the number of procedures, in fact the there might be a temptation to perform more of them to make up for the lost income ! What the American Health System needs is an uncoupling of payments from procedure volume.

Source: DigitaldocMD



anyway you could provide a link w this? I want to believe it but cant seem to find anything related
 

Gimlet

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anyway you could provide a link w this? I want to believe it but cant seem to find anything related
yep that's what I've been asking for myself.
C'mon guys, it only took 3 minutes of Googling and 4 minutes of browsing through this monster document to find this list...not sure how this author came up with these composite numbers, though, because the list above is much simplified:

Check out page 61983
http://edocket.access.gpo.gov/2009/pdf/E9-26502.pdf
 

RussianJoo

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C'mon guys, it only took 3 minutes of Googling and 4 minutes of browsing through this monster document to find this list...not sure how this author came up with these composite numbers, though, because the list above is much simplified:

Check out page 61983
http://edocket.access.gpo.gov/2009/pdf/E9-26502.pdf
thank you, i didn't want to read through 61,983 pages to find it. i thought the op would have a link available since he copied it from there.
 

gasaddict54

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so if I am reading this correctly, I see that anesthesiology got 3 % and crna got 4%......not 6% but still 3 % is still positive
 

Gimlet

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thank you, i didn't want to read through 61,983 pages to find it. i thought the op would have a link available since he copied it from there.
I found the article from lfesiam's original post by Googling, too, but the link the author had to his source was broken. So I have no idea how the discrepancies between the article's chart and this document's came up...maybe a newer version? Or just creative math.
 

lfesiam

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I found the article from lfesiam's original post by Googling, too, but the link the author had to his source was broken. So I have no idea how the discrepancies between the article's chart and this document's came up...maybe a newer version? Or just creative math.
hey dudes, been workin' hard treating Gomers, little time to post. Found it randomly while googling.

here is the link: http://mdsalaries.blogspot.com/2009/07/2010-specialist-salary-cuts-primary.html

not sure about the formula for the percentage. but i think this is a great step forward, even if it is a baby step :)
 
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