These three physicians recently connected with Becker’s to share the top change they want CMS to make this year.
Note: Responses were lightly edited for clarity and length.
Question: What is one thing you’d like to see CMS change in 2025?
Michael Firstenberg, MD. Cardiac surgeon of Maui Memorial Medical Center (Wailuku, Hawaii): The biggest change that I would like to see is the elimination of (or serious modification to) the 90-day global payment for surgical procedures. As a cardiothoracic surgeon we do an aortic valve replacement. We get paid a single amount and are responsible for all of the post-op care for 90 days with no real opportunities for additional billing/payments for each encounter. If a cardiologist (with help of a surgeon) puts in an aortic valve they can bill for the daily encounters and so on.
Another broader idea that I have had for some time is if what you do doesn’t work then you don’t get paid. I see many patients going back for multiple interventions and procedures, and each time it is a huge billing opportunity. This is especially true when a patient is dying and yet, there is that last billing opportunity (be it in the cath lab, chemo therapy, surgery, etc) before they die. If a patient dies, you don’t get paid? Not to mention the errors, including radiologists misreading x-rays and CT scans with no accountability.
If we are going to see serious healthcare reform in our lifetime then everyone needs to have skin in the game. Right now insurance companies are taking the beatings in the public eye, but there is so much fraud that I see on a daily basis.
Amit Singh, MD. Cardiologist of Cayuga Health (Ithaca, N.Y.): CMS needs to stop with continued rate cuts.
Rick Snyder, MD. President of HeartPlace (Dallas): The thing I want to see changed is site neutrality, no question about it!