| Posted: 30 March 2010 at 9:18pm | IP Logged | 7
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Kevin,
I don't know the full details of your situation so I cannot comment intelligently upon it one way or the other. And, if you forgive my bluntness, what you may believe -- and what I believe for that matter -- is completely irrelevant. I can only deal in the facts with which I am most familiar, and present them in a clear and dispassionate manner.
I do know the situation in my wife's practice. I know the cost of vaccines. I know the cost of her needles. I know the cost of her time, her rent, her utilities, her staff. And I can compute the time her biller will invest to recoup that Medicare charge with all the back-and-forth and delays in payment.
Sticking with a vaccination scenario, I know that the Medicare reimbursement for that procedure, less 21 percent, is now less than the cost of the vaccine. Think about that for a moment: the Medicare reimbursement for that shot she gives to her patient doesn't cover the cost of the vaccine, let along the cost of the needle, or her time, or any of the overhead. Again, I'm not asking for your belief. I am asking you to recognize cold, hard facts.
Further, when you consider that many insurers pay based on a factor of Medicare reimbursement -- the Medicare base rate plus x -- then the lowering of Medicare reimbursement rates inevitably leads to a reduction in other reimbursement rates from various carriers, all the while other costs continue to increase, reducing her margins. As those margins are thin to begin with, and one would like to avoid firing staff in a poor economy, the only option is to add more patients (preferably non-Medicare) to the daily schedule which means my wife working longer hours, or spending less time with each patient.
Neither is a particularly optimal solution.
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