American Medical News reports that MedPAC, which advises Congress on Medicare, recommended significant cuts to specialists to prevent such cuts for primary care physicians. An excerpt:
The Medicare Payment Advisory Commission has drafted recommendations to Congress that would block a 29.5% pay cut scheduled for 2012 and future across-the-board Medicare rate reductions, but the plan would pay for the changes by lowering rates for nonprimary care services. Supporters of the proposal said it could provide more stability to future payments under the Medicare program. But detractors warned that the concept would split the physician community and pit primary care physicians against specialists.
MedPAC policy analysts explained the proposal during a Sept. 15 meeting. Recommendations would set two fee schedules — one for primary care services and another for all other services. Payment rates for primary care would remain flat over 10 years, while payments for nonprimary care services would decline 5.9% a year for three years and then remain flat.
The 15-member commission is scheduled to vote on the proposal in October. If approved, the nonbinding recommendations would be delivered to lawmakers.
Total annual Medicare payments to physicians would rise from $60 billion in the first year of the decade to $120 billion in the 10th year. However, the conversion factor used for the primary care fee schedule would be about 20% higher than the conversion factor used to calculate final rates for all other services.
Specialists typically earn more than primary care physicians, and this fact partly accounts for the shortage of primary care physicians, as more medical students opt to specialize. MedPAC seeks to lessen the impact reduced payments would have on these doctors, but at what cost to specialties?
