Six physicians joined Becker's to discuss the impact of recent 2.83% physician pay cuts finalized by CMS, sharing their concerns about how these reductions could affect the healthcare system, physician practices and patient care.
Editor's note: These responses were edited lightly for clarity and length.
Tan Chen, MD. Orthopedic Surgeon at Geisinger Health (Wilkes Barre, Pa.) Physician reimbursement continues to lag behind inflation, and this next set of cuts by CMS will only further rub salt in the wound. These consecutive cuts are simply not sustainable for many practices and will ultimately further drive away Medicaid patients from receiving quality and specialized care.
Devin Datta, MD. Orthopedic Surgeon in Merrittville, Fla. Instead of dealing with the growth and expense of healthcare administration, CMS has once again cut those providing the care. At some point physicians will no longer want to deal with the low pay and requirements to participate in Medicare.
Khaldun Khatib, MD. Gastroenterologist at Hunt Regional Specialists (Greenville, Texas). It's demoralizing, as we are facing cuts in the face of inflation and other sectors actually are getting a pay increase
Thomas Loftus, MD. Neurosurgeon at the Austin (Texas) Neurosurgical Institute. The CMS pay cut is a disgrace. As every industry in America is being forced to adjust their pricing due to the out of control inflation over the past two to three years, physicians are being hammered. Not only are we not receiving inflation-adjusted increases in reimbursement, but the government is actually continuing to whittle away at our practice revenue overall. There will be, and already has been for so many, a breaking point in which it no longer makes sense to practice medicine. We will all become simple hospital or private equity employees with little autonomy. It is very possible that this is simply the way our government plans to take over healthcare without actually saying it out loud. Death by a thousand cuts.
Rick Richter, MD. Anesthesia Associates of Rock Hill (S.C.). As you may be aware, the overall reduction of 2.83% is for the physician portion of CMS but the impact on anesthesiologists is even larger (what amounts to about a 3.12% reduction in base units on average — the impact varies from state to state). Moreover, the percentage of healthcare dollar expenditure for physician services continues to decline.
While I believe that containing healthcare costs is a very important strategy in keeping overall government expenditures under control, I am concerned that increasing the cost burden on physicians is taking a toll in the recruitment and retention of physicians, especially in light of the U.S. facing an anesthesiologist shortage which is projected to be about 6,300 anesthesiologists short in 2035. And we are a specialty that is attractive to medical students seeking a specialty; imagine what this means for the primary care specialties such as family practice! Furthermore, continued reduction in CMS reimbursements will continue to drive the reliance on physician extenders and reduce the amount of personal interaction between patients and their physicians.
These cuts will also continue to erode physicians' autonomy in delivering healthcare to US citizens, making them more reliant on healthcare systems to employ them. Moreover these cuts will continue to have a devastating impact on the private practice physician model in the US and may very well drive it to extinction. Overall, I believe it will eventually have a negative impact on the overall health and wellbeing of community health in the U.S.
Stephen Swetech, MD. Family Medicine Physician in Clinton Township, Mich: For starters, having been an independent private practice small business owner as well as an employed physician previously, with almost three decades of experience working in various venues including family medicine evaluation and treatment, addiction medicine treatment, hospitalized patient management, extended care facility patient management, industrial/occupational medicine treatment, and medical provider teaching, to mention a few, I feel I am qualified to respond. Be advised that a 3% reduction in reimbursement, added to previous reductions, seems inconsequential to the lay public presently being economically stressed but can be catastrophic to a medical practice's bottom line, especially a small practice with one- to three-provider practices. Small private practices, the mainstay of care for the country's populace, are said to make up about 40% of the total overall medical clinics. They are unable to withstand the sustained negative impact of America’s poor economy. Larger group practices generally have more cash reserves and can withstand this reimbursement reduction burden easier for a short period of time but will eventually buckle under the loss of revenue.
Indirectly, the poor economy limits client access/visits and vendor reimbursements. The auto industry here in Michigan, once the center of our nation’s financial stability, delivering a decent wage and health insurance benefits, is now severely reduced and limited. People just cannot afford to go to the doctor. Physicians caring for the needy receive reduced Medicaid reimbursements, which impacts finances as well and leads to access-to-care issues. An additional unforeseen consequence of financial loss and practice closures is the reduction of teaching sites and opportunities for our future providers. The bottom line: a reduction in reimbursement to a struggling practice is intolerable, leading to financial issues for the practice and limited access for our sick, struggling patients! Inform the powers that be that instead of a reduction in reimbursement, they should be delivering a payment increase for the health of the country.