On July 10, CMS proposed a 2.8% conversion factor reduction to its physician fee schedule.
Five physicians joined Becker's to discuss how this decline will affect private practice and the independent workforce, among other concerns.
Editor's note: These responses were lightly edited for clarity and length.
Ernest Braxton, MD. Spine and Neurological Surgery Specialist at Vail-Summit Orthopaedics and Neurosurgery (Vail, Colo.): As many of my colleagues have pointed out, the proposed CMS pay cut for physicians can have significant implications across the healthcare system. CMS efforts to control costs will have unintended consequences on physician workforce morale, patient care quality and healthcare access. This will be the last straw for many private practice physicians. We will see more early retirements and a large number of physicians opting out of Medicare in order to create private pay contracts with patients for non-urgent/emergency care — shifting the economic burden to healthcare consumers.
Brian Gantwerker, MD. Neurosurgeon at the Craniospinal Center of Los Angeles: I believe the Medicare payment cut is in line with CMS' unwritten mandate to kill private practice and fee for service. Some wayward brain trusts in HHS will have people believe doctors' fees are still driving healthcare costs. I think we all know that's been false all along, especially now since over 70% of doctors are now employed. HHS and CMS are facilitating the failure of our healthcare system and benefiting insurers and hospital systems while doing it.
Nameer Haider, MD. Interventional Pain Specialist and Owner of Omni Pain & Precision Medicine (Utica, N.Y.):
- Reduced revenue: A pay cut translates directly to reduced revenue for surgical practices, which can strain financial resources. This can be especially challenging for small or independent practices.
- Operational costs: Fixed costs like staff salaries, rent and equipment maintenance remain unchanged, so a decrease in reimbursement rates can lead to financial imbalances.
Amit Mirchandani, MD. Founder of Seva Pain and Wellness (Lewisville, Texas): The CMS proposal to cut physician pay is a terrible idea. Not because I’m a physician myself, but because of the shift of attention, care and control away from physicians, which ultimately hurts patients in need. Putting financial pressures on already burnt out physicians is a flawed long-term solution to improving healthcare.
Instead of focusing on innovation and quality of patient experience, financially stretched physicians continue to become distracted with trying to make ends meet with office overheads. This is especially true after the immense inflation seen over the last few years. It’s simple. Costs have gone up. Reimbursements down. Physicians, like any other profession, will only tolerate that math for so long.Those physicians in smaller practices or underserved areas have had to become employed or even close down. This is a big problem in the U.S. as the big cities are drawing a larger portion of graduating physicians, leaving our rural communities having to travel far distances for quality and access of care.