Boiled down to one word, the outlook for physicians in 2010 is uncertain.
“The big question right now is what will happen with Medicare payment rates in 2010,” said Bill Jessee, MD, president and CEO of the Medical Group Management Association, about a healthcare reform package in Washington that could reduce Medicare payments to physicians by 21 percent. By March 31.
A proposed House bill would repeal the 21 percent cut, but there is currently no companion bill in the Senate. Many physicians have indicated they’ll close their doors to new Medicare patients if the cuts are made.
Physicians have to figure out how to forecast their finances when such a big payment item is up in the air. A lot of MGMA members have prepared two budgets – one if the cuts are made and one if they’re not.
“It’s ironic that reform wants to give everyone access to healthcare insurance, yet the physician cuts would be counterproductive,” said Jessee.
Donald Fisher, president and CEO for the American Medical Group Association, says the nation’s healthcare system won’t be able to weather a cut of that magnitude.
“It’s hard to predict what’s coming,” he said. “Financial implications are probably the most uncertain in years.”
“In healthcare reform, if the House were to prevail, and we end up with a public option tied to Medicare rates – about 80 cents on the dollar – the influx of 20 million people won’t make it up on the dollar,” said Fisher. He said people in fair or poor health will start consuming healthcare dollars.
In addition, he said, when millions more patients are added to the healthcare stream, many will seek care at hospital emergency departments because the nation is still facing a shortage of physicians.
“It will be a bit of a mixed bag in 2010 – $80 billion in nationwide grants have been allotted for capital funding grants. The states are pretty well strapped for cash, (and) needs could be balanced in 2010,” said Doug
Thompson, director of clinical services for the Columbia Basin Health Association in Othello, Wash.
He said state funding cuts would cut insurance for 100,000 people in Washington state, leaving more than a million people in the state without insurance.
Columbia operates federally qualified health centers in Mattawa, Othello and Connell, which assure access to all patients regardless of the ability to pay. Thompson said the association gets grant money to supply this care, but that funding isn’t included in the American Recovery and Reinvestment Act.