The elimination of Medicare's consultation codes has had a negative impact on physician efforts to improve care coordination and reduced the treatment options available to Medicare patients, according to a new survey.
The survey, released by medical specialty societies and the American Medical Association, indicates that specialists use consultation codes most frequently after a patient referral from a primary care physician.
Approximately 5,500 physicians who completed the survey have been forced to take cost-cutting steps to offset revenue losses associated with the elimination of these codes, according to officials.
According to the survey:
- 30 percent have reduced services to Medicare patients or are contemplating cost-cutting steps that will impact care.
- 20 percent have eliminated or reduced appointments for new Medicare patients.
- 39 percent will defer the purchase of new equipment and/or information technology.
- 34 percent are eliminating staff, including physicians in some cases.
- Following CMS' suggestions that specialists no longer need to provide primary care physicians with a written report, about 6 percent have stopped providing the reports, while another 19 percent plan to stop providing them.
After analyzing survey data, representatives of these specialties and the AMA identified several technical improvements that would make the policy more equitable. They joined with 16 other organizations in a letter outlining their concerns and asking the Centers for Medicare and Medicaid Services to review and modify its policy to prevent further deterioration of care coordination between physicians.
"A review of CMS' current policies regarding physician consultations is clearly called for," the letter said. "Revenue losses for consultant physicians are larger than projected. Physicians have been forced to reduce services to Medicare patients and care coordination has suffered as a result of the policy."
The organizations that signed the letter are the American Academy of Dermatology Association, American Academy of Neurology Professional Association, American Academy of Otolaryngology-Head and Neck Surgery, American Association of Clinical Endocrinologists, American Association of Neurological Surgeons, American College of Cardiology, American College of Gastroenterology, American College of Osteopathic Internists, American College of Osteopathic Surgeons, American College of Physicians, American College of Radiation Oncology, American College of Rheumatology, American Gastroenterological Association, American Geriatrics Society, American Medical Association, American Medical Group Association, American Osteopathic Academy of Orthopedics, American Psychiatric Association, American Society for Gastrointestinal Endoscopy, American Society for Radiation Oncology, American Society for Reproductive Medicine, American Society of Addiction Medicine, American Society of Clinical Oncology, American Society of Hematology, American Society of Plastic Surgeons, American Thoracic Society, American Urological Association, Congress of Neurological Surgeons, Heart Rhythm Society, Infectious Diseases Society of America, Joint Council of Allergy Asthma and Immunology, Society for Cardiovascular Angiography and Interventions, The Endocrine Society and The Society of Thoracic Surgeons.