• The doc fix dance

    I’ve been down on the AMA’s strategies in the past for trying to pitch a “doc fix” as part of deficit reduction. However, that doesn’t mean that it’s not a problem that doesn’t need a solution. It’s the bad penny that keeps turning up:

    If Congress can’t finish its homework before it goes on recess, it might be able to get an extension — but only if it’s willing to trim its winter break.

    At least, that’s the case with the “doc fix” — a temporary change to Medicare’s troubled provider payment formula that Congress must pass to prevent a deep cut to physicians. They face a 27 percent payment cut that starts Jan. 1 unless Congress acts.

    But Jan. 1 isn’t a do-or-die deadline. The Centers for Medicare & Medicaid Services can buy Congress a little breathing room — as it has done before — by holding physician payments for a brief period in the new year if it looks as though Congress will move quickly to update the fee schedule.

    I have absolutely no doubt that this will get fixed. Physician fees won’t drop 27%. I do, however, think that there could be a period in early January when payments get held.

    And that has consequences. Physician offices and hospitals have to cover the shortfall. They, and their staff, have to fight with Medicare. It wastes time, and it wastes money. Every time this happens, it raises our health care spending, it hurts quality, and it likely hurts access. It’s bad all around.

    I may disagree with the approach of the AMA some times, but I agree with the outcome. We need to fix this, permanently, and soon. Here’s Sarah Kliff with some options, and Austin with some more.


    • It will always get fixed. It is usually the rally call of the Republicans trying to save the program from itself even though the Democrats are saying they are trying to kill it. This also compounds the lack of a raise in the fees for 10 years or so I hear. If the fee levels are not kept up, then participation by doctors will plummet which might justify draconian measures that Democrats would love. Already some specialists basically work for free after billing costs (and overhead?). I was poking around the web and basically the fraud costs for Medicare are equal to the fraud costs for the entire private industry if memory serves. Why not increase investigations? Government and fraud investigations seem to be incompatible.