The federal government could cut payments to doctors by 37 percent during the next nine years for patients enrolled in Medicare.
The American Medical Association is lobbying for changes in the formula, which limits funding to a predetermined “sustainable growth” guideline.
“If the cost of services grows more than that rate in any one year, Congress in the next year will have to cut the amount of payments for individual services,” said Dr. Cecil Wilson, AMA board chairman.
It does not take into account changes to care required by Congress, the aging of the American population or new, more expensive cutting-edge treatments and drugs, he said.
“Physicians should be reimbursed based on the costs of providing medical care,” Wilson said.
He said that in informal surveys, 45 percent of primary-care physicians said they would have to limit the number of Medicare recipients they accept or stop treating Medicare patients if the funding changes go through according to the existing formula.
The AMA is lobbying Congress to support a bill by Rep. Michael Burgess, R-Texas ? Medicare Physician Payment Reform Bill and Quality Improvement Act of 2006 ? that would change the reimbursement formula. Nearly 80 senators have signed a letter to congressional leaders supporting a change in the formula.
The problem, Wilson said, is that commercial insurance carriers often set their reimbursement rates based on what the federal government pays for specific services.
In the long run, medical students could shy away from money-losing jobs as general practitioners and instead become specialists for a better return on their school investments.
Dr. Donald Wilson, dean of the University of Maryland School of Medicine, expressed similar concerns during an earlier interview with The Examiner.
“They take care of the hospital; the physician is left out,” Wilson said.
According to a report from the Government Accountability Office, Maryland ranks last in the nation for reimbursing doctors for medical care.
