2014: The End of Solo Practice for Physicians?

In Miami-Dade County, physicians in solo practice are facing constant economic challenges as a consequence of increases in office expenses and increases in the cost of living versus lower or no increase in reimbursements from insurance companies.

 

A decrease of 24% in Medicare reimbursement was anticipated to take effect January 1, 2014. However, key House and Senate committee members, approved legislation to repeal the Sustainable Growth Rate formula (SGR), which is used by CMS to pay physicians who are treating Medicare beneficiaries, and agreed to replace it with a short-term different formula known as “Doc Fix”, which will probably maintain the reimbursement levels about the same. The 24% decrease is now postponed until the end of the first quarter of 2014.

 

Senate Finance Committee Chairman Max Baucus (D-Mont.), Senate Finance Committee Ranking Member Orrin Hatch (R-UT), House Ways and Means Committee Chairman Dave Camp (R-MI), House and Means Committee Ranking Member Sander Levin (D-MI), House Emergency and Commerce Committee Chairman Fred Upton (R-MI) and House Emergency and Commerce Committee Ranking Member Henry Waxman (D-CA) applauded this progress toward replacing the SGR Formula.

 

There are several goals in this proposal: 1. Repeal the SGR formula, which will be permanent; 2. Improve the fee for service system; 3. Create incentives for alternative payment models to encourage physicians and providers to focus more on coordination and prevention; and 4. Make Medicare more transparent by giving patients more access to information and physician’s data. Now the legislation moves out of committees and onto the floor. If it passes, it has to be signed by the President.

 

However, if this legislation is not passed and the SGR formula remains in place, there will be a change in the way physicians practice medicine and in how we are reimbursed throughout the nation.

 

In Miami-Dade County, there will be devastating changes. Physicians in solo practice will need to face major decisions about the future of their practice. Most likely, many will have to close the doors of their practice. They will either join a group practice, become employed by clinics or hospitals or dramatically change their patient population and see “cash only” patients, hence, will not see Medicare or Medicaid beneficiaries. This will have a major effect on the economy in Miami-Dade County. Also, every physician in solo practice employees at least 3-5 persons. This support staff will be unemployed.

 

We must not let this happen. We have worked hard to build our practices, to earn our patient’s trust and ultimately to deliver quality health care.

 

We must act now and get involved. Prepare a short note, 5-6 lines at most. E-mail it to your U.S. Congressman and U.S. Senators in Washington. Talk to your peers; encourage them to do the same. Very importantly, talk to your patients, especially those who are Medicare beneficiaries. They potentially stand to lose the most! The time to act is now.

 

Un abrazo