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Medicare Payment Issue Brief

Due to a variety of technical changes the Centers for Medicare and Medicaid Services (CMS) included in the 2010 Medicare Physician fee schedule, nearly all services performed by cardiologists will see payment cuts ranging from 10 to more than 40 percent over four years.  The cuts are separate from health reform and do not include custs due to the sustainable growth rate (SGR) formula, and are on top of other payment policies already absorbed by cardiology practices. The impact on individual practices is causing many to take drastic measures according to a recent survey:

  • Half of private practice cardiology has integrated into a hospital or is considering it; another more than 10 percent has merged into another practice or is considering it.
  • Nearly three-fourths of private practices have taken some form of cost-cutting or service limiting action.
  • More than half of private practices have reduced staffing to save expenses.
  • Other cardiologists are retiring early at a time when there is already a cardiology workforce shortage.

The dismantling of private practice means Medicare beneficiaries will pay higher co-pays for services and likely wait longer for tests as they receive care in the outpatient setting rather than at a private practice. It also means higher costs to the Medicare system since many services cost more in the hospital outpatient setting. Read more on the 2010 rule. Find out what's on deck for cardiology in 2011.