I am a private practice physician in Iowa, and will also withdraw from participation in Medicare the day that proposed cuts in March go into effect. Medicare reimbursement here in Iowa is already about 50% of commercial coverage for procedures, and about 60% of commercial for the office codes I bill. A 20% reduction would bring the latter figures down to about 50% -- ergo, I make the same amount of money by seeing one commercial insurance patient. I can guarantee that you will see much more of what Mayo is doing in AZ moving forward, and as this happens, people will be reminded of the fact that having insurance does not equal having access. The people in Washington making these decisions have no idea what it is like to try to run a practice and make payroll in the face of these constantly dwindling reimbursement rates.
You tell me where the lunacy lies. My wife recently underwent a scan to diagnose back pain. The unexpected discovery was a kidney stone, and the recommended treatment was lithotripsy.
This outpatient surgical procedure consumed the better part of one day, and left her in constant pain, as a result of which I finally had to take her to the hospital's emergency facility.
From there she was admitted, and overnight a stent replaced, after which the pain was diminished, and controllable.
The total billing for this procedure exceeded $35,000: $12,000 for the surgeon, $19,000 for the hospital, $4,000 for anesthesia.
The hospital bills have not yet been paid by the Medicare Advantage insurer, but the Doctors received less than 10% of their billing.
Who is crazy here? The providers who invent the preposterous charges, or Medicare, which determines the miniscule payments?
It seems to me that the patient (called a "beneficiary"!) and the insurer are both caught in the middle.
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I am a private practice physician in Iowa, and will also withdraw from participation in Medicare the day that proposed cuts in March go into effect. Medicare reimbursement here in Iowa is already about 50% of commercial coverage for procedures, and about 60% of commercial for the office codes I bill. A 20% reduction would bring the latter figures down to about 50% -- ergo, I make the same amount of money by seeing one commercial insurance patient. I can guarantee that you will see much more of what Mayo is doing in AZ moving forward, and as this happens, people will be reminded of the fact that having insurance does not equal having access. The people in Washington making these decisions have no idea what it is like to try to run a practice and make payroll in the face of these constantly dwindling reimbursement rates.
You tell me where the lunacy lies. My wife recently underwent a scan to diagnose back pain. The unexpected discovery was a kidney stone, and the recommended treatment was lithotripsy.
This outpatient surgical procedure consumed the better part of one day, and left her in constant pain, as a result of which I finally had to take her to the hospital's emergency facility.
From there she was admitted, and overnight a stent replaced, after which the pain was diminished, and controllable.
The total billing for this procedure exceeded $35,000: $12,000 for the surgeon, $19,000 for the hospital, $4,000 for anesthesia.
The hospital bills have not yet been paid by the Medicare Advantage insurer, but the Doctors received less than 10% of their billing.
Who is crazy here? The providers who invent the preposterous charges, or Medicare, which determines the miniscule payments?
It seems to me that the patient (called a "beneficiary"!) and the insurer are both caught in the middle.
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