Physicians Fighting to Fend Off Steep Medicare Payment Cuts

Physicians in California and all across the country are worried about drastic cuts in Medicare payments that, under current law, are scheduled to take effect over the next nine years. A campaign led by the American Medical Association (AMA) helped avert an across-the-board 5 percent cut in 2007 Medicare physician payments, and the AMA is leading an all-out effort to stop a 10 percent cut in payments for 2008.

If Congress does not act, Medicare physician payment cuts could total 40 percent over the next nine years. The stakes are particularly high in California, where the state's physicians could lose nearly $23 billion for the care of elderly and disabled patients by 2016. California has more Medicare beneficiaries than any other state, and at 242 practicing physicians per 100,000 people, the state already has a below-average physician-to-population ratio, even before the cuts have taken effect.

The AMA is ramping up the pressure on federal lawmakers to stop the physician payment cuts, replace the flawed sustainable growth rate formula with a system that reflects the economic realities of practicing medicine, and level the playing field between the traditional Medicare program and Medicare Advantage plans. As part of the effort, the AMA has provided testimony to several congressional committees and has taken its National House Call campaign to several states this summer, most recently in Maine, Minnesota and Oregon. The AMA also has launched an ad campaign in newspapers and on the airwaves in key areas to highlight the urgency of this issue.

A recent AMA Member Connect Survey provides a snapshot of how the cuts would affect seniors. The survey found that 60 percent of physician respondents plan to limit the number of new Medicare patients they treat if payments are cut by 10 percent in 2008. Worse, if cuts totaling 40 percent are instituted by 2015, 77 percent of physician respondents said they would limit the number of new Medicare patients they treat.

AMA member Nathan Laufer, MD, a Phoenix-based cardiologist, is concerned such deep cuts would have a devastating effect on medically underserved communities. "When you start cutting reimbursements so doctors have difficulty running offices, then you're driving the physicians that are here either to other parts of the country or to other lines of work," Dr. Laufer said.

The financial discrepancies of Medicare Advantage plans, and the inconveniences they generate for patients, only add to matters. Medicare Advantage plans are paid on average 12 percent more than traditional fee-for-service providers--to the tune of $65 billion over five years and $160 billion over a decade. The AMA survey found that 80 percent of physicians said Medicare should stop subsidizing Medicare Advantage plans, a figure consistent with a recommendation by the Medicare Payment Advisory Commission, which has called for Medicare to pay the same amount regardless of which Medicare option a patient chooses.

Physicians are invited to visit www.ama-assn.org/go/grassroots to join the AMA Physicians' Grassroots Network and advocate for a solution.

Scholarship Lifts Local Student

Southern California medical student Cherie C. Cross was one of 11 medical students awarded a $10,000 scholarship in the form of an AMA Foundation Minority Scholars Award. In her second year at the David Geffen School of Medicine at the University of California, Los Angeles, Cross plays an active role in organized medicine, which she finds to be instrumental to her medical education and career.

"I feel that being a great physician is more than just being 'book smart,'" said Cross, an AMA, California Medical Association and Los Angeles County Medical Association member. "You must know how to be a leader, interact well with people and be aware of the needs of those that you will be serving."

The Minority Scholars Awards--given in collaboration with the AMA Minority Affairs Consortium, with support from the Pfizer Medical Humanities Initiative--recognize scholastic achievement and promise for the future among first- or second-year minority medical students.

"As medical students, we are in a position to do things such as sponsor health fairs and act as mentors to premedical students--while also collaborating with local medical organizations so that we continue to develop into socially aware physicians." said Cross.

Cross said she foresees her future "as a physician who will continue to lead in medical organizations," she said. In addition, she plans to practice in communities that do not have enough doctors.

Visit www.ama-assn.org/go/medicaleducation to view a complete list of Minority Scholars Award recipients and other scholarship opportunities.