'System collapse' looming with unchecked physician pay cuts, surgeon says

Many physicians are shocked and confused by Medicare's physician fee schedule proposed rule for 2023, which would reduce the conversion factor by 4.42 percent. 

Cory Calendine, MD, an orthopedic surgeon at the Bone and Joint Institute of Tennessee in Franklin, joined Becker's to discuss his concerns with increased cuts to physician pay.

Editor's note: These responses were edited lightly for clarity and length. 

Question: If CMS follows through with its proposed 4.42 percent physician pay cut, how will physicians & patients be affected?

Dr. Cory Calendine: Physicians, those standing closest to the patient and essential for patient care, are facing incredible inflationary pressure in the maintenance of their practices and offices. They have increasing staff and supply costs which are making continued viability more difficult. Larger economic factors are contributing to this inflationary pressure, but the COVID-19 effect is undeniable. To be facing these rising costs and then to have the largest governmental payer suggest a reduction in reimbursement is seemingly tone deaf to the physician ecosystem and its current difficulties. Without physicians, we will not have coordinated patient care. Patients will suffer.

Q: How will the healthcare industry shift if physician payments continue to decline?

CC: The outcome of this continued declining reimbursement combined with rising costs will be physicians seeking shelter from the financial storm, meaning additional physician employment by larger health systems, and/or, worse, a reduction in the physician workforce overtime. Presumably a portion of the care can be provided by advanced practitioners; however, there will likely be declining quality and availability of physician services. The physician spend represents a small portion of the total Medicare spend, making this approach seem shortsighted — if not entirely inappropriate. This path is unsustainable and will lead to system collapse if unchecked.

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