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Teaching Hospitals Fight Medicare Cuts
by
Julian Pecquet
January 17, 2012
Picture Credit: Chris Ware/Newsday
Teaching hospitals are ramping up the pressure on lawmakers to reject
cuts to their Medicare payments as Congress seeks to avert an almost 30
percent cut to physician rates on March 1.
Proposed cuts to hospital outpatient departments, the Association of
American Medical Colleges warned Tuesday, would be "counter-productive
and would reduce teaching hospitals' ability to provide outpatient care
to vulnerable populations, and will make it more difficult to train
physicians and other health care providers in an integrated, team-based
environment."
The warning is included in a three-page letter sent to a bipartisan
panel of lawmakers who are negotiating a payroll tax cut extension and
a fix to the Medicare physician payment formula.
The letter comes after the Medicare Payment Advisory Commission
(MedPAC), which advises Congress on Medicare payments, voted last week
to recommend cuts to hospital outpatient departments that could save
the government between $1 billion and $5 billion over the next five
years. The proposal is seen as a possible offset for the so-called "doc
fix," which costs about $30 billion for every year that scheduled cuts
to physician Medicare rates are delayed.
MedPAC voted 15-2 last week to recommend that Medicare reimburse
doctors' visits at the same rate, whether they take place in a hospital
or a physician's office. The panel says Medicare currently pays 80
percent more for the same routine visit if it takes place in a hospital
setting.
The AAMC in its letter says the impact of any cuts to outpatient
departments should be studied before they are implemented, rather than
after the fact, as proposed by MedPAC. The letter goes on to say that
outpatient departments operated at a negative 9.6 percent average
Medicare margin in 2010.
The hospitals, the letter argues, offer unique services not offered in
physicians' offices, including coordinated care for patients with
chronic or complex conditions, including cancer.
"Reducing support for [hospital outpatient departments] would create
strains," the letter says, "and could impose barriers to continuing
these important patient care coordination activities."
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