Doctors say practices disrupted by piecemeal Medicare payment fixes

News outlets report on workforce issues affecting doctors and nurses.

"Doctor groups are warning congressional leaders that a series of short-term measures lawmakers passed earlier this year to block Medicare payment cuts were too disruptive to medical practices," CQ HealthBeat reports. "To keep doctors from bailing out of the program, Congress should pass a longer term fix that lasts through 2011, they say. It won't be easy for Congress to kick its habit of short-term fixes, however. Billions of dollars in offsets elsewhere in the federal budget will be needed to cover the costs of future payment patches. ... The current payment patch expires Nov. 30. If Congress doesn't act, Medicare payments to doctors are scheduled to be cut by 23 percent on Dec. 1, and by another 6.5 percent on Jan. 1" (Reichard, 10/6).

Miami Today reports that it's becoming increasingly difficult to run a doctor practice. "With rising costs associated with healthcare reform and the prospect of lower payments for services, private practitioners are between a rock and a hard place. Healthcare reform is hitting physicians in private practice hard, said Robin Fielding, CEO of Orthopaedic Center of South Florida in Plantation. 'We are constantly under a lot of pressure from every avenue in managing our business,' she said. As with most businesses, she said, the cost of providing benefits for employees is skyrocketing due to preemptive rate hikes from insurance companies and a new electronic health record system. "At a recent conference of orthopedic executives, she said, compliance issues also loomed large. Compliance on everything from technology and Medicare to the 1996 Health Insurance Portability and Accountability Act will require much more paperwork" (Bowden, 10/6).

Meanwhile, The Washington Post reports that a nurse labor dispute at Washington Hospital Center "reflects growing rancor across the country at a time when the role nurses play in the country's evolving health-care system is set to become more critical then ever: The success of the sweeping health-care legislation will depend heavily on primary-care givers, such as nurses, whom President Obama has called 'the beating heart of health care'… The country's more than 3 million nurses already make up the largest segment of the health-care work force. Millions more will be needed to take care of the 32 million additional people who are estimated to get health insurance coverage in 2014… But during a recession, with their salaries being targeted, nurses across the country are unhappy" (Sun, 10/6).

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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.