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10-19-05-LIABILITY UPDATE - Stop Medicare physician payment cuts and protect patients - Part 1
10/19/05
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Wednesday, October 19, 2005
by Donna Baver Rovito, Editor, "Liability Update"
Author, "Pennsylvania's Disappearing Doctors"
This LIABILITY UPDATE "newsletter" is a free service which I provide, as a volunteer, to help provide medical liability reform and crisis information to physicians, patients and physician advocates. I do not work for any physician advocacy organization.
Opinions and clarifications are my own, and do NOT reflect the official position of any physician or patient advocacy organization unless stated as such. Opinions are placed in double parentheses ((xxxxxx)), italicized and appear in blue.
This Update is emailed to approximately 7,500 health professionals and physician and patient advocates.
PLEASE FORWARD THIS IMPORTANT INFORMATION TO EVERY HEALTH CARE PROFESSIONAL YOU KNOW AND SEND ME MORE EMAIL ADDRESSES
1....Commentary
2....AMA Website
Take action - Stop Medicare cuts
3....Morning Call - Letters
Medicare cuts will affect quality of care in Pennsylvania
4....PR Newswire
New Study Demonstrates Medical Liability Insurance is Fairly Priced
Experts Refute Claims by Center for Justice and Democracy
5....Medical News Today.com
Mundy bill would protect health-care whistleblowers, USA
6....My response to Medical News Today
7....Harrisburg Patriot Letters
Expert medical panels should decide cases
8....The Delaware County Daily Times
Local Voices: Re-electing Santorum right choice for Pa.
9....PA Medical Society Release
President says distribution system broken
10...Introduction of Senator John Rafferty at recent physician-sponsored event
1....Commentary
EVERY physician needs to tell his or her US Senator and member of Congress that PATIENTS will lose access to care if the proposed Medicare cuts aren't stopped.....There isn't a physician anywhere who can continue to absorb decreases that will total 26% in the next several years if something isn't done - and the only way our legislators will know how critically this decision will impact their constituents is if YOU tell them. Use the AMA's easy contact method in Item 2 below...
Several items feature the ever-popular debunking of Dark Side falsehoods.....you'll especially enjoy the letters in Item 7.
It was my pleasure this past weekend to attend the PA Medical Society's annual Alliance convention and PMS House of Delegates meeting - MANY THANKS to all the kind people who commented on and thanked me for my work. As always, it is an honor to fight alongside of Pennsylvania's dedicated doctors and the spouses and other advocates who support them.
So go call your Senator already....
DBR
2....AMA Website
Take action -- AMA in Washington - Stop Medicare cuts
The AMA is urging all U.S. physicians and medical students to work together and stop severe cuts to Medicare physician payments.
Urge your Senators and Representative to stop physician Medicare cuts
Congress has only a few weeks left in this year’s legislative session to fix Medicare’s broken payment system. If Congress fails to act in the next few weeks, Medicare will cut physician payments by 4.4 percent on January 1, 2006, and by 26 percent over the next six years.
Stop Medicare physician payment cuts and protect patients
Tell your federal representatives to fix Medicare’s broken payment system
http://capwiz.com/ama/mail/oneclick_compose/?alertid=8104801
There are three bills in Congress—S. 1081 in the Senate and H.R. 2356 and H.R. 3617 in the House—that would protect America’s patients by stopping drastic Medicare physician payment cuts over the next two years. Tell your representatives to stop Medicare physician payment cuts by supporting these bills.
If Congress does not act soon, Medicare will cut physician reimbursements by 26% over the next six years—including a 4.4% cut on January 1, 2006. These cuts threaten patients’ access to care, as many physicians will be forced to decrease the number of new Medicare patients they can treat.
Take action today! Use the form below to send an e-mail to both your U.S. Senators. Tell them to protect America’s patients by stopping Medicare physician cuts!
Talking Points
If Congress doesn’t act soon, Medicare will cut reimbursement payments to physicians by 26% over the next six years—including a 4.4% cut on January 1, 2006. These cuts could harm America's seniors by creating an access to medical care crisis.
These Medicare cuts will hurt America’s patients. A recent AMA Member Connect survey found that 38% of physicians will decrease the number of new Medicare patients they accept as a result of the first round of cuts in 2006.
For the sake of America's patients, these cuts must be stopped. If not, Medicare payment rates in 2014 will be little more than half what they were in 1991, after adjusting for practice cost inflation. As it is, Medicare payments already lag behind increases in practice costs.
Physicians are the foundation of the Medicare program: prescription drugs, diagnostic tests, and medical treatment all require physician involvement. Physician payment updates are driven by a flawed formula called the Sustainable Growth Rate, or SGR. Instead of the SGR, payment updates should be based on increases in practice costs.
Other Medicare providers are not subject to the SGR. In fact, hospital payments are slated to rise by more than 3% a year.
Please protect America’s patients and physicians by stopping these Medicare physician payment cuts.
3....Allentown Morning Call - Letters
Medicare cuts will affect quality of care in Pennsylvania
October 17, 2005
The clock is ticking on fixing a flawed and unfair system that will limit the number of physicians who may provide essential care in the future. Medicare payments to Pennsylvania are scheduled to be cut by at least $116 million in January. And, from 2006-2014, the cuts are to total $5.7 billion.
These cuts are coming at a precarious time for our nation's health care. The baby boomer generation is reaching retirement age, and the number of seniors in America also is rapidly rising. The demand for physician services also is growing. But the flawed Medicare reimbursement schedule is serving as a disincentive for medical students to choose to go into internal medicine, family practice and other specialties that our seniors depend on for their care.
Doctors are paid for their services to Medicare patients using rates established by the federal Medicare Physician Fee Schedule. The rates are determined using a mechanism called the sustainable growth rate, or SGR, formula. Right now, a cut of 4.4 percent for each Medicare service is to go into effect this January, and future cuts are projected to decrease physician reimbursements through Medicare by more than 26 percent over six years.
The formula unfairly ties the Medicare payments to an arbitrary budget that does not take into account patient needs. As a result, Medicare payments to physicians keep decreasing while the cost for doctors to provide care keeps climbing.
Today, Pennsylvania has 2,110,470 Medicare patients being treated by 40,542 physicians. But 34 percent of those physicians are over the age of 55 and approaching retirement. ((And only 3.5% of Pennsylvania's physicians are under the age of 35 - compounded by the fact that only 8% of residents training in Pennsylvania say they'll stay here to practice....this is a BIG problem....)) Future doctors must be encouraged to provide care for the growing number of patients. Nationally and within our state, the number of physicians going into internal medicine and family practice has declined precipitously. Although many factors affect specialty choice, medical students are ''voting with their feet'' by rejecting the specialties that take care of the most Medicare patients.
Clearly, as the number of Medicare enrollees increases, so will their demand for physician services. Due to increased numbers of patients going to doctors who do accept Medicare patients, waiting times for appointments are sure to be longer. These pressures are certain to increase the need for more primary care doctors to take care of Medicare patients.
On top of the strain these additional patients will place on the program, the federal government is beginning several initiatives to improve the quality of health care. These initiatives call for increased reporting of how physicians perform based on measures of good patient care, thereby increasing the time-pressure on physicians. The initiatives also increase physician expenditures through the need to invest in health information technology, such as electronic health records.
Several recently published studies call attention to the need for improvement in the quality of health care. The New England Journal of Medicine published a study that showed that patients were only receiving about 55 percent of recommended care for various conditions and treatments. From this statistic alone, it is easy to see why improvements need to be made. Payment cuts undermine the ability of physicians to invest the time and resources required to improve health care quality.
In a 2003 article in the Journal of the American Medical Association, Pennsylvania ranked 31st in the nation in terms of the average state-wide performance on provision of effective care to Medicare patients.
The projected Medicare cuts may keep internists from participating in quality improvement programs because we will not be able to afford the electronic health records systems that are needed to participate in such programs. A new study found that widespread adoption and effective use of electronic health record systems and other health information technology improvements could save the U.S. health system as much as $162 billion annually, greatly reducing preventable medical errors, lowering death rates from chronic disease, and reducing employee sick days. But the same study found that electronic health records cost a physician on average $33,000 per month, plus maintenance costs of $1,500 per month. Few doctors will be able to afford this if the federal government goes ahead with reducing Medicare reimbursement. In Pennsylvania, the average physician is due to lose $18,000 per year due the projected cuts.
The elderly and disabled patients of Pennsylvania expect Congress to do what is necessary to improve health care access and quality. Congress must fix the flawed and unfair Medicare payment system before it is too late.
John P. Fitzgibbons, M.D., is a physician in Allentown, and the governor of the Pennsylvania Eastern Chapter of the American College of Physicians.
((This is one of the best expressions of what will happen if the scheduled Medicare payment cuts occur that I've seen - many thanks to Dr. Fitzgibbons for writing it....I'm sure he wouldn't mind if others sent similar letters to their OWN local newspapers....))
4....PR Newswire - (Daily Insurance Reporter)
New Study Demonstrates Medical Liability Insurance is Fairly Priced
Leading Academic Experts Refute Claims by Center for Justice and Democracy
October 14, 2005
((MANY experts have refuted the biased and nonsensical "study" by the CJD which claimed that medical liability insurers were "gouging" doctors and creating a fake medical liability crisis....this is a worthy addition to the other REAL analyses of the situation...))
WASHINGTON -- A comprehensive analysis of the financial performance of the medical liability insurance industry by two of the nation's top academic experts in the field found no evidence that medical liability insurance is overpriced, or that insurance companies are to blame for a health care liability crisis that is forcing good doctors out of medicine and putting patients at risk.
The new study, "Profitability in Medical Professional Liability Insurance," was completed by Dr. Robert E. Hoyt, the Dudley L. Moore Chair of Insurance at the University of Georgia's Terry College of Business, and Lawrence S. Powell, the Whitbeck-Beyer Chair of Insurance and Financial Services at the University of Arkansas College of Business. It was released today by the Health Coalition on Liability and Access (HCLA), a broad-based group of health care providers. ((And look, the sponsoring organization isn't hiding who it is behind fake names and affiliations....))
In their report, Drs. Hoyt and Powell specifically and conclusively refute claims made in a recent study by Mr. Jay Angoff ((a personal injury lawyer and longtime supporter of Ralph Nader)) and released by the Center for Justice and Democracy, a study they call "critically flawed" and full of "errors and shortcomings."
"The Hoyt-Powell report represents a comprehensive analysis of the medical liability insurance industry over the past nine years," said Christian Shalgian, HCLA Chair. "Contrary to claims made by the Center for Justice and Democracy, the report shows that the medical liability crisis our nation is facing is not caused by insurers earning excess profits or overpricing their coverage. Rather, the medical liability crisis is caused by excessive litigation and the lottery-sized verdicts."
In their report, Drs. Hoyt and Powell develop a measurement of financial performance in the medical malpractice industry using a complete set of costs and revenues reported on insurers' annual financial statements for all companies that report data to regulators. This measurement, called the Economic Combined Ratio, found that the average profit ratio, or return on net premiums earned during the period 1996-2004 by medical liability insurers, was negative 13 percent.
The Hoyt-Powell report is consistent with other recent studies of the medical liability insurance market, including a report released in 2004 by the National Association of Insurance Commissioners and the 2003 study by Government Accountability Office. Both of these studies found that losses on medical liability claims are the main factor influencing rate increases. The findings of the Hoyt-Powell report are also similar to those recently published by actuaries James D. Hurley and Gail E. Tverberg of Towers Perrin, who found Angoff's statistics to be "meaningless and unsound ... materially incomplete ... and taken out of context."
The Hoyt-Powell report can be found at http://www.hcla.org.
For more details, visit http://www.hcla.org. Health Coalition on Liability & Access is a national advocacy coalition of organizations representing doctors, hospitals, health care liability insurers, long-term care facilities, health care insurers, employers, and health care consumers. HCLA believes federal legislation, including reasonable limits on non-economic damages, is needed to bring fairness, timeliness and cost-efficiency to America's medical liability system.
SOURCE Health Coalition on Liability and Access
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10-19-05-LIABILITY UPDATE - Stop Medicare physician payment cuts and protect patients - Part 1
by Donna Baver Rovito, Editor, "Liability Update"
Author, "Pennsylvania's Disappearing Doctors"
This LIABILITY UPDATE "newsletter" is a free service which I provide, as a volunteer, to help provide medical liability reform and crisis information to physicians, patients and physician advocates. I do not work for any physician advocacy organization.
Opinions and clarifications are my own, and do NOT reflect the official position of any physician or patient advocacy organization unless stated as such. Opinions are placed in double parentheses ((xxxxxx)), italicized and appear in blue.
This Update is emailed to approximately 7,500 health professionals and physician and patient advocates.
PLEASE FORWARD THIS IMPORTANT INFORMATION TO EVERY HEALTH CARE PROFESSIONAL YOU KNOW AND SEND ME MORE EMAIL ADDRESSES
1....Commentary
2....AMA Website
Take action - Stop Medicare cuts
3....Morning Call - Letters
Medicare cuts will affect quality of care in Pennsylvania
4....PR Newswire
New Study Demonstrates Medical Liability Insurance is Fairly Priced
Experts Refute Claims by Center for Justice and Democracy
5....Medical News Today.com
Mundy bill would protect health-care whistleblowers, USA
6....My response to Medical News Today
7....Harrisburg Patriot Letters
Expert medical panels should decide cases
8....The Delaware County Daily Times
Local Voices: Re-electing Santorum right choice for Pa.
9....PA Medical Society Release
President says distribution system broken
10...Introduction of Senator John Rafferty at recent physician-sponsored event
1....Commentary
EVERY physician needs to tell his or her US Senator and member of Congress that PATIENTS will lose access to care if the proposed Medicare cuts aren't stopped.....There isn't a physician anywhere who can continue to absorb decreases that will total 26% in the next several years if something isn't done - and the only way our legislators will know how critically this decision will impact their constituents is if YOU tell them. Use the AMA's easy contact method in Item 2 below...
Several items feature the ever-popular debunking of Dark Side falsehoods.....you'll especially enjoy the letters in Item 7.
It was my pleasure this past weekend to attend the PA Medical Society's annual Alliance convention and PMS House of Delegates meeting - MANY THANKS to all the kind people who commented on and thanked me for my work. As always, it is an honor to fight alongside of Pennsylvania's dedicated doctors and the spouses and other advocates who support them.
So go call your Senator already....
DBR
2....AMA Website
Take action -- AMA in Washington - Stop Medicare cuts
The AMA is urging all U.S. physicians and medical students to work together and stop severe cuts to Medicare physician payments.
Urge your Senators and Representative to stop physician Medicare cuts
Congress has only a few weeks left in this year’s legislative session to fix Medicare’s broken payment system. If Congress fails to act in the next few weeks, Medicare will cut physician payments by 4.4 percent on January 1, 2006, and by 26 percent over the next six years.
Stop Medicare physician payment cuts and protect patients
Tell your federal representatives to fix Medicare’s broken payment system
http://capwiz.com/ama/mail/oneclick_compose/?alertid=8104801
There are three bills in Congress—S. 1081 in the Senate and H.R. 2356 and H.R. 3617 in the House—that would protect America’s patients by stopping drastic Medicare physician payment cuts over the next two years. Tell your representatives to stop Medicare physician payment cuts by supporting these bills.
If Congress does not act soon, Medicare will cut physician reimbursements by 26% over the next six years—including a 4.4% cut on January 1, 2006. These cuts threaten patients’ access to care, as many physicians will be forced to decrease the number of new Medicare patients they can treat.
Take action today! Use the form below to send an e-mail to both your U.S. Senators. Tell them to protect America’s patients by stopping Medicare physician cuts!
Talking Points
If Congress doesn’t act soon, Medicare will cut reimbursement payments to physicians by 26% over the next six years—including a 4.4% cut on January 1, 2006. These cuts could harm America's seniors by creating an access to medical care crisis.
These Medicare cuts will hurt America’s patients. A recent AMA Member Connect survey found that 38% of physicians will decrease the number of new Medicare patients they accept as a result of the first round of cuts in 2006.
For the sake of America's patients, these cuts must be stopped. If not, Medicare payment rates in 2014 will be little more than half what they were in 1991, after adjusting for practice cost inflation. As it is, Medicare payments already lag behind increases in practice costs.
Physicians are the foundation of the Medicare program: prescription drugs, diagnostic tests, and medical treatment all require physician involvement. Physician payment updates are driven by a flawed formula called the Sustainable Growth Rate, or SGR. Instead of the SGR, payment updates should be based on increases in practice costs.
Other Medicare providers are not subject to the SGR. In fact, hospital payments are slated to rise by more than 3% a year.
Please protect America’s patients and physicians by stopping these Medicare physician payment cuts.
3....Allentown Morning Call - Letters
Medicare cuts will affect quality of care in Pennsylvania
October 17, 2005
The clock is ticking on fixing a flawed and unfair system that will limit the number of physicians who may provide essential care in the future. Medicare payments to Pennsylvania are scheduled to be cut by at least $116 million in January. And, from 2006-2014, the cuts are to total $5.7 billion.
These cuts are coming at a precarious time for our nation's health care. The baby boomer generation is reaching retirement age, and the number of seniors in America also is rapidly rising. The demand for physician services also is growing. But the flawed Medicare reimbursement schedule is serving as a disincentive for medical students to choose to go into internal medicine, family practice and other specialties that our seniors depend on for their care.
Doctors are paid for their services to Medicare patients using rates established by the federal Medicare Physician Fee Schedule. The rates are determined using a mechanism called the sustainable growth rate, or SGR, formula. Right now, a cut of 4.4 percent for each Medicare service is to go into effect this January, and future cuts are projected to decrease physician reimbursements through Medicare by more than 26 percent over six years.
The formula unfairly ties the Medicare payments to an arbitrary budget that does not take into account patient needs. As a result, Medicare payments to physicians keep decreasing while the cost for doctors to provide care keeps climbing.
Today, Pennsylvania has 2,110,470 Medicare patients being treated by 40,542 physicians. But 34 percent of those physicians are over the age of 55 and approaching retirement. ((And only 3.5% of Pennsylvania's physicians are under the age of 35 - compounded by the fact that only 8% of residents training in Pennsylvania say they'll stay here to practice....this is a BIG problem....)) Future doctors must be encouraged to provide care for the growing number of patients. Nationally and within our state, the number of physicians going into internal medicine and family practice has declined precipitously. Although many factors affect specialty choice, medical students are ''voting with their feet'' by rejecting the specialties that take care of the most Medicare patients.
Clearly, as the number of Medicare enrollees increases, so will their demand for physician services. Due to increased numbers of patients going to doctors who do accept Medicare patients, waiting times for appointments are sure to be longer. These pressures are certain to increase the need for more primary care doctors to take care of Medicare patients.
On top of the strain these additional patients will place on the program, the federal government is beginning several initiatives to improve the quality of health care. These initiatives call for increased reporting of how physicians perform based on measures of good patient care, thereby increasing the time-pressure on physicians. The initiatives also increase physician expenditures through the need to invest in health information technology, such as electronic health records.
Several recently published studies call attention to the need for improvement in the quality of health care. The New England Journal of Medicine published a study that showed that patients were only receiving about 55 percent of recommended care for various conditions and treatments. From this statistic alone, it is easy to see why improvements need to be made. Payment cuts undermine the ability of physicians to invest the time and resources required to improve health care quality.
In a 2003 article in the Journal of the American Medical Association, Pennsylvania ranked 31st in the nation in terms of the average state-wide performance on provision of effective care to Medicare patients.
The projected Medicare cuts may keep internists from participating in quality improvement programs because we will not be able to afford the electronic health records systems that are needed to participate in such programs. A new study found that widespread adoption and effective use of electronic health record systems and other health information technology improvements could save the U.S. health system as much as $162 billion annually, greatly reducing preventable medical errors, lowering death rates from chronic disease, and reducing employee sick days. But the same study found that electronic health records cost a physician on average $33,000 per month, plus maintenance costs of $1,500 per month. Few doctors will be able to afford this if the federal government goes ahead with reducing Medicare reimbursement. In Pennsylvania, the average physician is due to lose $18,000 per year due the projected cuts.
The elderly and disabled patients of Pennsylvania expect Congress to do what is necessary to improve health care access and quality. Congress must fix the flawed and unfair Medicare payment system before it is too late.
John P. Fitzgibbons, M.D., is a physician in Allentown, and the governor of the Pennsylvania Eastern Chapter of the American College of Physicians.
((This is one of the best expressions of what will happen if the scheduled Medicare payment cuts occur that I've seen - many thanks to Dr. Fitzgibbons for writing it....I'm sure he wouldn't mind if others sent similar letters to their OWN local newspapers....))
4....PR Newswire - (Daily Insurance Reporter)
New Study Demonstrates Medical Liability Insurance is Fairly Priced
Leading Academic Experts Refute Claims by Center for Justice and Democracy
October 14, 2005
((MANY experts have refuted the biased and nonsensical "study" by the CJD which claimed that medical liability insurers were "gouging" doctors and creating a fake medical liability crisis....this is a worthy addition to the other REAL analyses of the situation...))
WASHINGTON -- A comprehensive analysis of the financial performance of the medical liability insurance industry by two of the nation's top academic experts in the field found no evidence that medical liability insurance is overpriced, or that insurance companies are to blame for a health care liability crisis that is forcing good doctors out of medicine and putting patients at risk.
The new study, "Profitability in Medical Professional Liability Insurance," was completed by Dr. Robert E. Hoyt, the Dudley L. Moore Chair of Insurance at the University of Georgia's Terry College of Business, and Lawrence S. Powell, the Whitbeck-Beyer Chair of Insurance and Financial Services at the University of Arkansas College of Business. It was released today by the Health Coalition on Liability and Access (HCLA), a broad-based group of health care providers. ((And look, the sponsoring organization isn't hiding who it is behind fake names and affiliations....))
In their report, Drs. Hoyt and Powell specifically and conclusively refute claims made in a recent study by Mr. Jay Angoff ((a personal injury lawyer and longtime supporter of Ralph Nader)) and released by the Center for Justice and Democracy, a study they call "critically flawed" and full of "errors and shortcomings."
"The Hoyt-Powell report represents a comprehensive analysis of the medical liability insurance industry over the past nine years," said Christian Shalgian, HCLA Chair. "Contrary to claims made by the Center for Justice and Democracy, the report shows that the medical liability crisis our nation is facing is not caused by insurers earning excess profits or overpricing their coverage. Rather, the medical liability crisis is caused by excessive litigation and the lottery-sized verdicts."
In their report, Drs. Hoyt and Powell develop a measurement of financial performance in the medical malpractice industry using a complete set of costs and revenues reported on insurers' annual financial statements for all companies that report data to regulators. This measurement, called the Economic Combined Ratio, found that the average profit ratio, or return on net premiums earned during the period 1996-2004 by medical liability insurers, was negative 13 percent.
The Hoyt-Powell report is consistent with other recent studies of the medical liability insurance market, including a report released in 2004 by the National Association of Insurance Commissioners and the 2003 study by Government Accountability Office. Both of these studies found that losses on medical liability claims are the main factor influencing rate increases. The findings of the Hoyt-Powell report are also similar to those recently published by actuaries James D. Hurley and Gail E. Tverberg of Towers Perrin, who found Angoff's statistics to be "meaningless and unsound ... materially incomplete ... and taken out of context."
The Hoyt-Powell report can be found at http://www.hcla.org.
For more details, visit http://www.hcla.org. Health Coalition on Liability & Access is a national advocacy coalition of organizations representing doctors, hospitals, health care liability insurers, long-term care facilities, health care insurers, employers, and health care consumers. HCLA believes federal legislation, including reasonable limits on non-economic damages, is needed to bring fairness, timeliness and cost-efficiency to America's medical liability system.
SOURCE Health Coalition on Liability and Access
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