As a result of Medicare Sustainable Growth Rate (SGR), physicians face Medicare payment cuts annually. Even though the Congress often steps in to stop the reductions, it has been reported that Medicare reimbursement for physicians will be slashed by 24.4% in 2014.
Physicians and senior citizens to bear the brunt:
Even though annual Medicare cuts are done when Medicare spending outpaces economic growth, it has affected patients as well as senior citizens in the US-
- Seniors relying on Medicare Advantage Program might lose doctors, benefits, plans and financial protection they currently enjoy
- Doctors will start turning away Medicare patients For instance, in 2012, Medicare patients looking for new primary care physicians had trouble finding doctors
- Impact of annual Medicare cuts is also being felt by physicians, especially private practices. They are finding it difficult to strike a balance between the treatment and keeping their practice open. The uncertainty is taking a toll on their practice. Since private insurers consider Medicare rates as the basis for their reimbursement rates, it is getting difficult for them to determine if they can afford to stay in business
- Access to care has also been affected due to annual Medicare cuts as practices are deciding to discontinue certain in-house tests. Cuts have also resulted in costly, unnecessary procedures
- Medicare payment cuts will also impact hospitals, forcing the management to bring necessary changes in staffing and services to increase efficiency. Due to reductions, growth of operating expenses and total revenue will slow down
- To bring down unnecessary hospital admission, more resources will have to be assigned for primary care. Since hospitals will gain or lose 1% of Medicare funding on the basis of 20 factors that gauge quality of care, necessary measures will have to be taken to avoid disruption in cash flow
Till Congress doesn’t fix this problem, necessary preparations will have to be done by practices to sail through the impending Medicare crisis. Approximately, 10,000 people gain eligibility for Medicare every day and with the current shortage of primary care physicians in the US, a dangerous situation will arise if doctors start limiting the type of patient they want to treat due to payment cuts.
Streamlined medical billing services- the key to dealing with Medicare cuts
Amidst challenges generated by Medicare cuts, other vitals tasks related to ICD-10, PQRS, HIPAA, and medical billing coding will also get affected due to lack of time and resources. In order to ensure efficiency in billing procedures and to maintain a smooth cash flow, practices are outsourcing their billing services.
Billing partners like Medicalbillersandcoders.com has been helping practices balance billing and Medicare cuts along with other ongoing healthcare changes. MBC has the largest consortium of billers and coders in the US and the latest technology is used to handle medical billing, HIPAA compliance and other vital processes. The aim is to maximize revenue and minimize claim denials for providers who are getting bogged down due to annual cuts in Medicare payments.