Medicare Pay Cut Delayed Until March 31

03/01/2010 - News

Medicare Pay Cut Delayed Until March 31

By: June Chen, MD


The U.S. House of Representatives has passed legislation to delay a 21.2% Medicare reimbursement cut that was scheduled to take effect on March 1, 2010. However, Congress will not pass legislation in time to avoid the March 1 implementation of the Medicare pay cut. This scheduled Medicare reimbursement reduction may affect the ability of many physicians to afford to see new Medicare patients.

In fact, this Medicare reimbursement cut may affect physicians’ ability to stay in the federal Medicare program or even remain in practice. Senior citizens may also have difficulty finding a physician who is willing to treat them, given that reimbursement rates will drop by more than one-fifth. This same bill to reduce Medicare reimbursement also includes temporary extension of unemployment benefits, COBRA subsidies, and other federal healthcare programs, and the argument against this bill is that its passage would add to the already large federal deficit. 

According to a recent poll of neurosurgeons, nearly 40% indicated that they would cut back on seeing new Medicare patients if Medicare reimbursement continues to fall. And, 18% of the neurosurgeons surveyed indicated that they would stop acceptingnew Medicare patients entirely. Even established Medicare patients are at risk, as 27% of these surgeons said they would treat fewer established Medicare patients if this bill is passed.

This 21.2% Medicare cut will grow to about 40% in cumulative reimbursement cuts by 2016 unless Congress acts to replace a payment update formula that has been called outdated by the American Medical Association (AMA) and other medical associations. Among the AMA’s core principles is the permanent reform of the Medicare physician payment system, and the AMA has urged Congress to include this initiative as part of the comprehensive health system reform in 2010.



American Medical Association website, accessed 28 February 2010.


Created on: 02/27/2010
Reviewed on: 03/01/2010

Your rating: None Average: 4 (2 votes)
Anonymous wrote 4 weeks 3 days ago

You are so right. People don't mind paying 20,000-50,000 for a care but OMG if they have to pay $150.00 for an office visit, they freak out. Yet your health is the most important thing. I have had patients who want me to treat them over the phone because they don't want to pay the $20 copay. These are the first people who will sue you for malpractice, People are unbelieveable.

Anonymous wrote 4 weeks 6 days ago

I don't know who these people are that are suggestsing that physicians have mismanaged their business and just play golf. Yes I am married to a physician, a cardiologist who works around 14 hours a day, 5 days a week and is on call every 4-5 weeks, which starts at five o'clock on Friday until 7am Monday. The first of January medicare decreased reimbursement on nuclear exams and echocardiograms done in the office by 36%. Two months later we are looking at another 21% across the board cut, which means that the nuclears and echos have taken a 57% hit which is more than half. That is about a break even rate. Good business tells you you can not make a living and support an office staff at that rate. Not to mention that these cuts in reimbursement did not affect the hospitals. Is that fair? About 65% of my husband's practice is medicare. I would like some business person tell me how you maintain a business with those kinds of cuts in reimbursement. Other businessis when their cost go up, they increase their prices. Doctors could charge a thousand dollars for an office visit but they are only going to get paid what medicare and the other insurance companies tell them they are getting. The technician that drives two hours to fix a piece of equipment in our office, charges 150.00 an hour including his driving time. Believe me he would not accept 21% less because I said that was all I was paying. I don't know what the answer is but we used American tax dollars to bail out poorly managed and greedy businesses. Those people still received a bonus for not doing their job. Maybe some of those tax dollars should have been but into the medicare system. People will pay many dollars to have their animals taken care of but think someone else is responsible for paying for their care. Our society no longer wants to take care of the elderly and educate the young. How did we get so screwed up?

Anonymous wrote 5 weeks 4 hours ago

I admit I'm not an advocate of allopathic medicine in general. I've worked as a critical care nurse for almost 20 years and have seen many things that I will never be able to tell and still be allowed to continue to work as a nurse. However, in all of those years I've seen 99% of the physicians I worked with spend more than the normal 40 hr work week that the rest of us complain about. They work hard, under a lot of stress, and for long hours. Those who are unfortunate enough to have the weekend "call" spend about 72 hours STRAIGHT taking care of patients' needs. Family Practice doctors in particular are already taking a huge hit. Yes, there are the specialty physicians such as some of the surgeons who buy huge houses and have several of those - we can't concentrate on them because they are not the norm. But again, how would you like to stand on your feet for up to 12 hours without taking a break doing a surgery? I've seen doctors go longer than that. My point is I guess we can't generalize about all physicians being on the gravy train - they're NOT. What we need to be looking at is they can and will stop seeing Medicare patients - period end of discussion. Now, I'm getting older and would like to think I could use Medicare, but my guess is it will be a long wait and a quick 5 minute visit - probably no labs or x-rays. I decided a long time ago it was up to ME to take care of myself, eat right, exercise and start researching those things that will keep me healthier longer without allopathic care. Besides once you get into the hospital, your changes of getting out are greatly reduced - and that chance gets lower and lower every year.

Anonymous wrote 5 weeks 16 hours ago

Firstly let me say this, I'm nt a doctor but the comments of #9 and #8 are what amke me sick about our country today. Neither of you understand what is takes to run a medical practice. These doctors aren't putting "SPIN" on anything they are flat out telling the truth. And worst all the people who are getting hurt in this as well the elderly most likely aren't able to get healthcare under other circumstances. Of course I am sure both of you are against healthcare reform which while it might cut some medicare payments it would allot for a greater number of people to have insurance and would more or less balance the cuts. As it is now this 20% cut in revenues wont be replaced costing not only the doctors, but as well causing unemployment of their employees.

Anonymous wrote 5 weeks 1 day ago

Blaming the doctors on this one? Wow, most here don't know the first thing about running a profitable healthcare related buisness. Those physicians in Private practices don't make millions of dollars. The bigger picture is that Medicare essentally sets the rates. Meaning Insurance companys will follow and make the 21% cut in reimbursement. Physical therapists in the private sector are screwed thats for sure. Imagine going to school for 7 years, getting your doctorate and making less then a personal traininer with no schooling out of highschool.

These medicare patients will essentially head to the hospital system. which in itself only worsens the shift

Anonymous wrote 5 weeks 1 day ago

As a physician let me point out that very few small businesses could survive a 20% revenue drop that came more or less out of the blue. You probably aren't aware that there have been major cuts already for 2010 and there were also big cuts in 2009, 2008, 2007...etc.

As as one of the anonymous posters said earlier all you have to do is look at your financials and decide what overhead to cut. Well, guess what, we are down to cutting employees as we've already cut our rent, office supplies, doctor salaries, equipment costs. No docs I know are "spinning" this story--unlike politicians and the Government we have to live within our means. BTW, I know very few docs who play golf or take days off. Here are some simple changes:
--Reform malpractice and insurance companies.
--Push back Medicare Eligibility to age 70.

Shame on me for "threatening elderly people"! How can you provide care if it you lose money every time you see a patient. I bust my buns every day keeping elderly people alive and improving their quality of life. You are either a moron or just clueless; besides what do you do to help the elderly and impoverished?

Anonymous wrote 5 weeks 1 day ago

To the two other docs, don't try to explain. Just make a plan B. Mine is to go overseas. There are plenty of places you can make good if not better money than here. And with significantly lower taxes. Singapore is one place. You could also become non-participating which will increase the fees about 15% (at the patient's expense) or just op out and do private contracts with patients.

Anonymous wrote 5 weeks 1 day ago

When I graduated high school, my father offered me half of the family construction company for which I worked throughout my childhood. My salary would have been in excess of $200k (not bad for an 18 year old kid). Seeing no challenge there, I chose to seek the path of most resistance. I too am now a surgical subspecialist. Not only did I have to be the best of the best of the best through my 15 year education, I went over $500k in debt, and lost over $200k/year for 15 years (in lost income). I do not expect to be rich, but I do expect decent reimbursement for a life dedicated to the benifit of others and all the sacrifices I have made (and continue to make). My practice is high overhead also (technology is not cheap). A 21.5% reimbursement reduction will put me and my employees on the street. I save lives every day, and I do not play golf. Treat me with respect.

Anonymous wrote 5 weeks 1 day ago

Five years ago I purchased a prominent 47 year old ophthalmology practice that employs 60 people. The other doctors I employ and I see over 27,000 office visits per year. Despite helping thousands of people per year to see, our overhead is over 80%. A 21% reimbursement cut will put us out of business, put 60 staff in the unemployment line, and leave close to 30,000 people per year with nowhere to go for their eyecare. I am the very best at what I do and could have done anything for a living. I chose to dedicate my life to helping others (not making money). To get into medical school, I had to be in the top 5% of my college graduating class (that's the top 1% of the general population). To get into ophthalmology, I had to be in the top 10% of my medical school class. To do a fellowship, I had to be in the top 10% of ophthalmologists. My work ethic and intelligence level are the top of the top of the top (1 in 10,000), and I do not play golf. I choose to dedicate my life to helping others see. This pay cut will put me out of business. In 1979 physician reimbursement for a cataract surgery was over $2100. Now it is less than $600. With this cut, it will be less than $500. Meanwhile, none of my overhead costs are less than they were in 1979. Doctors are the smartest people in society. Doctors are the hardest working people in society. Doctors deserve to make a decent living. We should be discussing a pay increase.

Anonymous wrote 4 weeks 3 days ago

I am an ophthalmologist looking to go into private practice. Do you think it is possible to "opt out" and only take cash/private insurance in our field ?

Anonymous wrote 5 weeks 1 day ago

There are very few golf outings and physicians are working twice as hard to make half as much as they were 10-20 years ago. This is while hospital CEO's and Insurance company executives are making millions. Be careful who you point your finger at or you might find yourself being taken care of by a poorly trained hack. While no one seems to complain about our athletes being paid millions of dollars ,the ones who cure cancer and heal the sick are constantly being attacked. Becoming a physician requires hard work and dedication as well as in most cases the creation of tremendous debt from school loans. There is no doubt our current medical system needs some changes, however, lets focus on where the real problem is. Believe it or not the doctors have already seen tremendous cuts in pay. Continue this trend and the best and brightest will no longer go to medical school. Most likely your future physician just served you a slurpee at 7-11!

Anonymous wrote 5 weeks 1 day ago

Funny. So what do the physicians think needs to be changed? You mention that "some" changes are necessary, but you never say what they are. What changes do you propose that we make to save money if it isn't cutting reimbursements?

Anonymous wrote 5 weeks 1 day ago

The physician spin on this story is truly amazing. Physicians are actually going to go out of business because of a 20% cut on a portion of their revenues? They must have a really big problem with managing their business if that is the case. What a good business person would do is take a look at their financials and figure out what overhead they needed to cut immediately. I am also appalled by the scare tactics that you use. Shame on you for threatening elderly people by telling them that you can't provide care to them because of this. That should be illegal.

Anonymous wrote 4 weeks 3 days ago

Medicine ia s business. If you can't turn a profit you have to close the doors. This is not socialized medicine. If it were ,you would be waiting for about 6 months to see a doctor and years longer to see a specialist. People don't hesitate to fork over 30 dollars for a pedicue but I have heard many complain about a 30 dollar copay. medicine is not a good given right.

Anonymous wrote 4 weeks 3 days ago

Have you ever checked an EOB? A typical family doctor makes an average of 50 dollars per visit. With a 20% reduction that goes down to 30 dollars. A typcial office has 50% overhead. Doctor overhead are not decreasing 20%.I bet the politician salaries don't decrease every year. Every year rent goes up, electricity goes up. This will not only decrease the quality of care but who do you think is going to spend 8 years of their lives to make a a lousy salary. I

Anonymous wrote 5 weeks 10 hours ago

As a group, physicians trimmed out the fat a long, long time ago. A further 20% cut would be all muscle and bone. Cutting Medicare reimbursement by 20% is just like cutting Social Security benefits by 20%. Tell a Social Security recipient that her benefits are being cut by 20% and to "just look at your financials and cut some costs" and see what kind of a response you get.

As a good business person, I have looked at my financials and figured out what overhead needed to be cut. The result? Medicare patients. Because it costs more to see Medicare patients than the revenue they generate (especially now), Medicare patients *are* overhead. They will be cut immediately as you suggest, with one caveat: Medicare patients are still welcome to see virtually any physician of their choice -- but it will have to be as self-pay patients. That's how it has been in our office for 5 years, since we saw this day coming. We just thought it would have occurred much sooner than now.

Anonymous wrote 5 weeks 1 day ago

Oh well, welcome to the Greatest Depression! It looks like you guys are gonna have to start making house calls for 5 more golf outings

Anonymous wrote 4 weeks 5 days ago

You, dear citizen, will have no one to call for that HouseCall visit !
You don't know much based on what you wrote here !
Yeah, welcome to the Great Depression !
I hope you go through it and stay healthy. A lot of people die during depression; no medical care.
I also hope that you have a doctor in your family - one that will see you for 5 bucks.

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