Medicare Again

Dear Friends and Colleagues:
Unfortunately, the Medicare reimbursement cuts are looming on the horizon AGAIN, but this time we have a hard time to stop the proposed cuts of 5.1%.
Already "doctors friendly" Republicans admit privately that the AMA campaign seeking to prevent the Medicare cuts amounts to piling during a difficult election season when Republicans are trying to hold onto control of Congress. According to media reports lawmakers are unlikely to raise Medicare payments to physicians since financing possibilities rankle “whoever’s ox is gored,” a Republican aide says.
According to Medicare officials the volume and intensity of medical care will push up costs for physician-related services by 5% next year.Without the planned reimbursement cuts of 40% until 2015, Part B spending would increase by a total of $2.8 billion in 2007. It is of interest to note that the reversal of this years planned cut of 5.1% would increase the Medicare premiums by only $1.50!
Many of our patients are not aware how those intended Medicare cuts are going to affect access to patient care. But according to an AMA survey once told about it, 86% are concerned about access to physician care in Medicare. When seniors —who tend to be a big voting bloc in midterm elections— are asked, 82% say they are concerned about access to physicians.
What are the solutions:
1) Inform your patients how those cuts will adversely affect their access to care
2) Support OUR AMA in the effort to stop the cuts. See the AMA web site for more information.
3) Consider opting-out of Medicare, which may be the a viable solution to safe your practice (I have done so 7 years ago)

What you should NOT DO: To ignore the looming crisis and to increase your patient load to "make up" for lost income. This is a flawed formula, because your overhead will increase exponentially leaving you with less profit or worse with a loss.

I also want to wish all of my fellow Jewish colleagues a Happy New Year, Shana Tova and Chatima Tova. For my Muslim brothers and Sisters I wish them a heartfelt joyous and blessed Ramadan,Ramdan- ul - mubarak.

Yours

Bernd



Most Medicare Part B Premiums to Rise Slightly
By JANE ZHANG
September 13, 2006; Page D4

WASHINGTON -- Most seniors will see a smaller-than-expected increase in their monthly Medicare premiums for physician and outpatient care next year, but for the first time in the program's history, wealthier beneficiaries will pay premiums based on their incomes.

The federal Centers for Medicare and Medicaid Services said most seniors will pay a $93.50 monthly premium for coverage under Medicare's Part B, $5 more than this year, and lower than the double-digit increase earlier projected, to more than $98.

Meanwhile, wealthier beneficiaries will pay premiums, ranging as high as $162 every month for individuals with annual incomes of more than $200,000 down to $106 a month for those earning more than $80,000. The higher premiums for next year will be based on incomes declared in the 2005 tax year and will be adjusted for inflation.

The change, based on the 2003 Medicare law, will affect about 1.5 million Americans and save the program $20.8 billion in the next 10 years, officials said.

Part B premiums generally cover 25% of Medicare's costs, with the government footing the rest. But as a result of the change, the subsidy for higher-income beneficiaries is expected to decline to as low as 20% from 75%.

Some analysts worry that the change will transform the Medicare health-insurance program into a welfare program for lower-income seniors. But CMS chief Mark McClellan said that only about 9,000 of the higher-income enrollees are expected to drop out next year and 30,000 by 2010, when the change is fully implemented. Even the wealthiest beneficiary will receive a good insurance package, he said, $4,363 for Part B benefits, or physician and outpatient care, for a $1,945 annual premium.

The increase in the standard Medicare premiums, by 5.6%, to $93.50, is lower than expected, largely because physicians are filing claims faster and getting paid more quickly, the government said. Part B premiums saw double-digit growth since 2001, when the premium was $50 every month.

Still, Medicare spending keeps rising. Costs for outpatient hospital care, while only 13% of total Part B spending, accounted for a third of premium increase in 2007, Medicare officials said. Those costs are expected to grow by 11.6% per capita in 2007, while volume and intensity of care will push up costs for physician-related services by 5% next year.

The premiums announced yesterday included calculations of a 5% cut in physician payments for 2007, but Congress has reversed such cuts four years in a row. And if lawmakers do it again this year, as urged by the American Medical Association, this would require an additional $1.50 increase in 2007 premiums, Dr. McClellan said.

Without the cut, Part B spending would increase by a total of $2.8 billion in 2007. Based on federal law, Medicare will reduce physician reimbursement by 40% in the next nine years.

If the cuts go through, the AMA said, nearly half of physicians surveyed will stop taking new Medicare patients, just as baby boomers are set to start turning 65 in five years. The AMA will unveil an advertising campaign today to urge Congress to reverse the cuts before the fall recess. Physicians will come to Washington to make a "house call" on lawmakers, the group announced.

But Congress is unlikely to act before November, some congressional aides say.