Rising healthcare costs and declining Medicare payments and are two key business challenges being faced by orthopedic practices. Due to the drastic impending cuts in professional fees, providers are finding it difficult to run their business smoothly. Many physicians have already left the Medicare program as they are unable to stay afloat in the current healthcare industry.
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Private payers and Medicare have such low rates that providers hardly make any profit by treating patients under these plans. Survival has become extremely difficult due to payment cuts combined with stringent healthcare reforms. For instance, orthopedic practices are required to prove their eligibility for Meaningful Use incentives by 2014 for which, they have to implement expensive EMRs and spend more time filling out forms rather than attending patients.
Efforts are being made by the American Association of Orthopedic Surgeons and other physician organizations to prevent these cuts by ensuring passage of a permanent fix to the SGR. However, it has become important for orthopedists to evaluate their options and create a contingency plan in case Congress fails to stop the implementation of Medicare payment cuts.
Medicare costs may have skyrocketed in last few years but payments to physicians, particularly for surgical procedures have plummeted. There is a negative gap between what orthopedists have to pay in practice and operational costs and what they obtain as reimbursement. This gap seems to be widening with every passing year.
Impact on payments from private insurers:
Medicare cuts have also impacted payments from private insurers. Reimbursement schedules of many commercial insurers are based on a percentage of Medicare reimbursement. Every time payment rates are reduced by Medicare, reimbursements from such private insurers are also reduced. Since orthopedic practices must rely on private insurance patients as increasingly necessary to make up for the cost of Medicare patient treatment, reduction in private payment has also posed threat to the existence of orthopedic practices.
Consequences of Medicare cuts:
Decline in physician fee is having negative consequences on orthopedic practices, such as:
- Physicians have started working for long hours which is affecting their productivity level
- Use of physician extenders has increased
- Many experienced physicians are taking early retirement due to rising pressure
- Less time is being spent on each patient due to high patient volume
- Many providers are abandoning their practice to get hospital jobs
- Delays are being caused in conversion to Electronic Health Records
How can streamlined billing help orthopedists?
Streamlined medical billing can bring an end to various challenges posed by Medicare cuts. If you want to stay in business and enhance your financial performance, don’t hesitate in seeking help from a billing company.
Billing partner such as Medicalbillersandcoders.com have been helping orthopedists run their practice smoothly. We have the largest consortium of coders and billers who will not only ensure maximum reimbursements but also offer assistance in implementation of electronic health records, HIPAA compliance, documentation and other administrative tasks. While we strengthen your revenue cycle, you can concentrate on provision of quality care.