Could your medical practice be in danger of closing its doors? 

This threat could be real, especially if you’re a physician who accepts Medicare. In December, President Joe Biden signed a $1.7 trillion end-of-year spending package into law, which, in part, cuts Medicare payment to physicians. The omnibus was initially passed by Congress to avoid a government shutdown, but lawmakers snuck in some new legislation that rewrote parts of Medicare policy. Some experts say this move threatens practices and patient access to care.

PHYSICIAN MEDICARE PAYMENT CUTS

Physicians will face a 2 percent cut this year for services delivered to Medicare patients and that total will be slashed again by at least 1.25 percent in 2024. It’s important to note: Medicare physicians initially faced a 4.5 percent reduction to payments for this year, but physician organizations and healthcare groups fought back against legislators to avoid deeper cuts. That’s some good news, for now. As a result of the cuts, the Centers for Medicare and Medicare Services (CMS) has updated the 2023 Conversion Factor to $33.8872. 

View the AMA Medicare Physician Payment Rule Summary here. 

“Medicare is paying less in 2023 than they’ve paid historically over the last 20 years, so that’s a huge impact to the practices,” explains Donna White, owner of Legacy Consulting Services. “It’s another reason for practices to consider outsourcing because they can work with a company that specializes in revenue cycle, medical billing and reimbursement analysis.”

FEELING THE IMPACT

Medicare accounts for 21 percent of national health spending and 10 percent of the federal budget and nearly 60 million Americans are enrolled as of 2020. Physicians haven’t seen a substantial Medicare pay raise in 20 years and several groups are calling for an overhaul of the Medicare system. Some doctors who care for older Medicare patients are concerned about how the cut will impact their access to care. Many practices, still reeling from the COVID-19 pandemic, will be forced to make some difficult decisions, like determining whether Medicare participation is still viable. Some doctors’ groups warn these cuts could lead to long-term shortages of doctors who treat Medicare patients, especially in rural or underserved areas. 

“When you think about it, expenses are higher, labor costs are higher, Medicare is reducing its claim rate. How do you compensate for all of that? These practices that were making around 8 percent might now be only making 2 percent or maybe they’re in the red,” says White.

HOW OUTSOURCING CAN HELP

By teaming up with Legacy Consulting Services, you’ll be working directly with an expert who understands Medicare reimbursement. You won’t have to worry about turnover or administrative burden. Here is a sampling of services we provide:

• Ensuring accurate Medicare payments
• Providing insight into how claims are processed
• Able to work on any system to allow for a seamless transition 
• Skilled, educated team members are ready to assist
• Accountability tools in place 
• Revenue cycle tracking (billing, payment posting, accounts receivable, rejections, denials, etc.)
• Transparency
• Run reports to ensure payment and reimbursements match

If you’re concerned about how the new Medicare pay cuts will affect you and other physicians, call Legacy Consulting Services today for a FREE consultation.