As operating costs continue to rise, low reimbursements weigh heavily on physicians.
Here is what five physicians have to say about their struggles with low reimbursements:
Jayesh Dayal, MD. Anesthesiologist at White Flint Surgery (Rockville, Md.): As a standalone ASC, we seem to have no negotiating power with any of the insurers and seem to be at the bottom of the procedure reimbursement rungs. The larger health systems, with access to hospital outpatient department rates and private-equity owned ASCs, with their nationwide heft, seem to be able to negotiate enviable rates for the same procedures. The days of standalone ASCs are numbered and we will be forced to sell or partner with these consolidators for survival, defeating the whole concept of physician autonomy and pride of ownership that motivates physicians to undertake ASC ownership in the first place.
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Alyson Engle, MD. Pain Medicine Physician at Northwestern Medical Group (Chicago): Procedure reimbursements have failed to keep up with inflation and do not reflect the increased work demands of physicians. Insurance company profits soar while physician salaries decline. Less physicians will be inclined to stay in the workforce as the economics do not make sense. This trend is unsustainable for our nation's health and will lead to lower quality care as physicians leave medicine. Many patients are forced to defer treatment, which can lead to higher direct and indirect healthcare costs for the entire country. Less profitable procedures will be cut out of service lines, which can also lead to worse health outcomes.
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Marsha Haley, MD. Clinical Assistant Professor of Radiation Oncology at the University of Pittsburgh: Declining reimbursement is a huge issue that leads to many other problems. Physicians do not receive an inflationary reimbursement update — in fact, Medicare physician pay has declined over 20% over the past 10 years. With inflation resulting in rising overhead costs, it becomes more difficult for private practices to remain viable. These practices are then vulnerable to purchase by large, vertically integrated health systems. Physicians and their patients may then become victims of the corporate practice of medicine, which results in increased physician burnout and a decline in the quality of care.
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Todd Harburn, DO. Orthopedic Sports Medicine Surgery Specialist (Mackinaw City, Mich.): Declining reimbursement for dedication and sincere hard work in providing medical care to patients and services will continue to have an effect on decisions as to where to, how to practice, or even remain in the profession/retire early, as has been seen recently across the country. The cold truth and reality is that the resolution of these concerns and problems is unlikely to be resolved easily or soon.
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Taif Mukhdomi, MD. Interventional Pain Physician at Pain Zero (Columbus, Ohio): Unfortunately, physicians are losing money in multiple scenarios in medicine. The most prominent loss of physician revenue is Medicare's consistent decreasing of physician reimbursement in office settings while supporting hospital-setting healthcare services. This trend affects all insurances, as Medicare is the benchmark of most if not all healthcare insurance reimbursement.
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