Physicians frustrated over planned rate cuts

Local doctors are frustrated that, yet again, Congress appears likely to stave off another year of planned cuts to Medicare physician payments without offering a permanent remedy.

Each year since 2003, doctors have lobbied against scheduled payment cuts, arguing that physicians would leave the program in droves if faced with significantly lower rates. And each year Congress has voted to delay the scheduled cuts for another year, leaving even larger cuts looming on the horizon.

But the annual ordeal is getting old, said Dr. Mack Worthington, a Chattanooga family physician. He sensed a frustrated fatalism at a recent meeting of the American Medical Association.

"We're tired of going back to Congress every year, fighting it and spending our time and energy and money trying to convince Congress to do something each year," he said. "We don't want any more piecemeal (solutions.) We want it done one way or the other. We want (the flawed formula) done completely away with, or let the cuts go on."

STRAINED DOCTORS

If a 21 percent cut went through, which most say is unlikely, local doctors say it would force them to limit their Medicare patients to keep their practices out of the red.

Any cut particularly would hurt rural doctors and their patients, who already face hardships trying to find doctors in remote areas, said Dr. Leonard Reeves, of Rome, Ga., president of the Georgia Academy of Family Physicians.

Dr. Reeves guessed the cuts will be averted again this year, but a long-term solution won't happen before January.

"I think it's too huge a battleship to turn on a dime," he said. "We're going to see this drag out until probably the winter or early spring" before a fix is in sight.

Elderly patients would struggle even more to find a doctor, said Laura Watkins, administrator at Chattanooga Family Practice.

"You'll start seeing practices refuse to see Medicare patients, and then where are these people going to go?" she said.

INSIDE THE NEW BILL

Last week, the House passed the Medicare Physician Payment Reform Act, HR 3961, which would avert the 21 percent cut to Medicare reimbursements scheduled for Jan. 1.

The bill also would revamp the formula for Medicare's sustainable growth rate, which routinely calls for cuts to physician payments, and replace it with a new formula that considers the rising cost of running a medical practice.

But the measure appears unlikely to pass Congress this year. Last month, the Senate rejected a similar bill, and the recently introduced health reform measure from Sen. Harry Reid, D-Nev., includes a provision that would delay the Medicare rate cut for another year without addressing the underlying formula.

Sen. Bob Corker, R-Tenn., said he is a staunch supporter of fixing the formula and avoiding doctor payment cuts, but he would not support a bill that adds billions to the federal deficit.

The Congressional Budget Office estimated the Medicare Physician Payment Reform Act would increase spending by $210 billion over 10 years.

Instead, Sen. Corker said, Congress should use the more than $400 billion in projected Medicare savings that would come from cutting inefficiencies and rooting out fraud to fund that portion of the bill as part of health care reform, he said.

"The notion of taking Medicare savings and not using them to solve these Medicare issues, whether it's (the sustainable growth rate) or making Medicare more solvent, to me is incomprehensible," he said.