{"id":5789,"date":"2015-11-28T04:03:59","date_gmt":"2015-11-28T12:03:59","guid":{"rendered":"http:\/\/associatednews.info\/content\/end-of-medicare-bonuses-will-cut-pay-to-primary-care-doctors\/"},"modified":"2015-11-28T04:03:59","modified_gmt":"2015-11-28T12:03:59","slug":"end-of-medicare-bonuses-will-cut-pay-to-primary-care-doctors","status":"publish","type":"post","link":"https:\/\/associatednews.info\/content\/end-of-medicare-bonuses-will-cut-pay-to-primary-care-doctors\/","title":{"rendered":"End Of Medicare Bonuses Will Cut Pay To Primary Care Doctors"},"content":{"rendered":"<p><span style=\"font-style:italic;font-size:16px\">By  <a target=\"_blank\" href=\"http:\/\/www.npr.org\/sections\/health-shots\/2015\/11\/28\/457148697\/end-of-medicare-bonuses-will-cut-pay-to-primary-care-doctors?utm_medium=RSS&amp;utm_campaign=healthcare\">Michelle Andrews<\/a><\/span>  <\/p>\n<div class=\"ftpimagefix\" style=\"float:left\"><a target=\"_blank\" rel=\"nofollow\" href=\"http:\/\/www.npr.org\/sections\/health-shots\/2015\/11\/28\/457148697\/end-of-medicare-bonuses-will-cut-pay-to-primary-care-doctors?utm_medium=RSS&amp;utm_campaign=healthcare\"><img decoding=\"async\" width=\"150\" src=\"http:\/\/media.npr.org\/assets\/img\/2015\/11\/23\/doctor-cost-cutting-42ecab319f6e1c0b4ac97980e9dc86657efb7fd1-s1100-c15.jpg\"><\/a><\/div>\n<div>\n<div><\/div>\n<div>\n<div>\n<p>&#8220;I&#8217;ve come for your Medicare bonus.&#8221; <strong>Laughing Stock\/Corbis<\/strong> <strong>hide caption<\/strong><\/p>\n<\/div>\n<p><strong>toggle caption<\/strong> <span>Laughing Stock\/Corbis<\/span><\/div>\n<\/div>\n<p>Many primary care practitioners will be a little poorer next year because of the expiration of a health law program that has been paying them a 10 percent bonus for caring for Medicare patients. Some say the loss may trickle down to the patients, who could have a harder time finding a doctor or have to wait longer for appointments. But others say the program has had little impact on their practices, if they were aware of it at all.<\/p>\n<p>The incentive program began in 2011 and was designed to address disparities in Medicare reimbursements between primary care physicians and specialists. It distributed $664 million in bonuses in 2012, the most recent year that figures are available, to roughly 170,000 primary care practitioners, awarding each an average of $3,938, according to a <a target=\"_blank\" rel=\"nofollow\" href=\"http:\/\/www.medpac.gov\/documents\/reports\/chapter-5-per-beneficiary-payment-for-primary-care-(june-2014-report).pdf?sfvrsn=2\">2014 report<\/a> by the Medicare Payment Advisory Commission.<\/p>\n<p>Although that may sound like a small adjustment, it can be important to a primary care practice, says Dr. Wanda Filer, president of the American Academy of Family Physicians. &#8220;It&#8217;s not so much about the salary as it&#8217;s about the practice expense,&#8221; she explains. &#8220;Family medicine runs on very small margins, and sometimes on negative margins if they&#8217;re paying for electronic health records, for example. Every few thousand makes a difference.&#8221;<\/p>\n<p>Doctors in family medicine, internal medicine and geriatrics <a target=\"_blank\" rel=\"nofollow\" href=\"https:\/\/www.cms.gov\/Medicare\/Medicare-Fee-for-Service-Payment\/PhysicianFeeSched\/Downloads\/PCIP-2012-Payments.pdf\">are eligible for the bonuses<\/a>, as are nurse practitioners and physician assistants.<\/p>\n<p>Medicare generally pays lower fees for primary care visits to evaluate and coordinate patients&#8217; care than for procedures that specialists perform. The difference is reflected in physician salaries. Half of primary care physicians made less than $241,000 in 2014, while for specialists the halfway mark was $412,000, according to the Medical Group Management Association&#8217;s <a target=\"_blank\" rel=\"nofollow\" href=\"http:\/\/www.mgma.com\/about\/mgma-press-room\/press-releases\/2015\/primary-care-physicians-outpace-specialists-in-2014-according-to-mgma-physicians-compensation-repor\">annual provider compensation survey<\/a>.<\/p>\n<p>The effect the bonus program is larger on practices with more Medicare patients. Dr. Andy Lazris estimates 90 percent of the patients that his <a target=\"_blank\" rel=\"nofollow\" href=\"http:\/\/www.personalphysiciancare.net\/\">five-practitioner practice<\/a> in Columbia, Md., treats are on Medicare.<\/p>\n<p>&#8220;When the bonus payments started, it was a pretty big deal for us,&#8221; Lazris says. The extra $85,000 they received annually allowed them to hire two people to deal with the administrative requirements for being part of an <a target=\"_blank\" rel=\"nofollow\" href=\"http:\/\/khn.org\/news\/are-medicare-acos-working-experts-disagree\/\">accountable care organization<\/a> and to help the practice incorporate two new Medicare programs related to managing patients&#8217; chronic diseases or overseeing their moves from a medical facility to home.<\/p>\n<p>Next year, if they can&#8217;t make up the lost bonus money by <a target=\"_blank\" rel=\"nofollow\" href=\"http:\/\/www.npr.org\/sections\/health-shots\/2015\/05\/11\/405955775\/family-doctors-who-do-more-save-more\">providing more services<\/a>, it&#8217;ll mean a pay cut of $17,000 per practitioner, Lazris says.<\/p>\n<p>The incentive program was an effort to address shortcomings in Medicare&#8217;s system of paying providers mostly a la carte for services, which tends to undervalue primary care providers&#8217; ongoing role in coordinating patients&#8217; care.<\/p>\n<p>The expiration of the Medicare incentive program comes on the heels of a <a target=\"_blank\" rel=\"nofollow\" href=\"https:\/\/www.acpservices.org\/sites\/default\/files\/shared\/documents\/leadership-day\/14\/briefing-materials\/expiring_payment_policies.pdf\">similar bonus program<\/a> for Medicaid primary care services that ended in 2014, says Dr. Wayne J. Riley, president of the American College of Physicians, a professional organization for internists.<\/p>\n<p>&#8220;There will be some physicians who say they can&#8217;t take any more Medicare patients,&#8221; Riley predicts.<\/p>\n<p>An attorney for an advocacy group for Medicare beneficiaries says they support the bonus payments and hope physicians won&#8217;t shut them out.<\/p>\n<p>&#8220;We don&#8217;t have any evidence to show that primary care docs will stop seeing Medicare beneficiaries without the payment bump,&#8221; says David Lipschutz, a senior policy attorney at the Center for Medicare Advocacy.<\/p>\n<p>The vast majority of nonpediatrician primary care doctors accept patients who are covered by Medicare, according to a <a target=\"_blank\" rel=\"nofollow\" href=\"http:\/\/kff.org\/medicare\/issue-brief\/primary-care-physicians-accepting-medicare-a-snapshot\/\">national survey<\/a> by the Commonwealth Fund and the Kaiser Family Foundation. But while 93 percent take Medicare, a smaller percentage, 72 percent, accept new Medicare patients. [Kaiser Health News is an editorially independent program of the nonprofit Kaiser Family Foundation.]<\/p>\n<p>Not all primary care practitioners will miss the incentive program, according to the Commonwealth\/KFF <a target=\"_blank\" rel=\"nofollow\" href=\"https:\/\/kaiserfamilyfoundation.files.wordpress.com\/2015\/06\/experiences-and-attitudes-of-primary-care-providers-under-the-first-year-of-aca-coverage-expansion.pdf\">survey<\/a>.<\/p>\n<p>Only a quarter of those surveyed said they received a bonus payment; half didn&#8217;t know the program existed.<\/p>\n<p>Of physicians who were aware of and received Medicare bonus payments, 37 percent said it made a small difference in their ability to serve their Medicare patients, and 5 percent said it made a big difference. However, nearly half\u201448 percent\u2014said it made no difference at all.<\/p>\n<p><em>This entry passed through the Full-Text RSS service &#8211; if this is your content and you&#8217;re reading it on someone else&#8217;s site, please read the FAQ at fivefilters.org\/content-only\/faq.php#publishers.<\/em><\/p>\n<p>Source:: <a href=\"http:\/\/www.npr.org\/sections\/health-shots\/2015\/11\/28\/457148697\/end-of-medicare-bonuses-will-cut-pay-to-primary-care-doctors?utm_medium=RSS&amp;utm_campaign=healthcare\" target=\"_blank\" title=\"End Of Medicare Bonuses Will Cut Pay To Primary Care Doctors\" rel=\"nofollow\">http:\/\/www.npr.org\/sections\/health-shots\/2015\/11\/28\/457148697\/end-of-medicare-bonuses-will-cut-pay-to-primary-care-doctors?utm_medium=RSS&amp;utm_campaign=healthcare<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<div class=\"ftpimagefix\" style=\"float:left\"><a target=\"_blank\" rel=\"nofollow\" href=\"http:\/\/www.npr.org\/sections\/health-shots\/2015\/11\/28\/457148697\/end-of-medicare-bonuses-will-cut-pay-to-primary-care-doctors?utm_medium=RSS&amp;utm_campaign=healthcare\"><img decoding=\"async\" width=\"150\" src=\"http:\/\/media.npr.org\/assets\/img\/2015\/11\/23\/doctor-cost-cutting-42ecab319f6e1c0b4ac97980e9dc86657efb7fd1-s1100-c15.jpg\"><\/a><\/div>\n<div>\n<div><\/div>\n<div>\n<div>\n<p>&#8220;I&#8217;ve come for your Medicare bonus.&#8221; <strong>Laughing Stock\/Corbis<\/strong> <strong>hide caption<\/strong><\/p>\n<\/div>\n<p><strong>toggle caption<\/strong> <span>Laughing Stock\/Corbis<\/span><\/div>\n<\/div>\n<p>Many primary care practitioners will be a little poorer next year because of the expiration of a health law program that has been paying them a 10 percent bonus for caring for Medicare patients. Some say the loss may trickle down to the patients, who could have a harder time finding a doctor or have to wait longer for appointments. But others say the program has had little impact on their practices, if they were aware of it at all.<\/p>\n<p>The incentive program began in 2011 and was designed to address disparities in Medicare reimbursements between primary care physicians and specialists. It distributed $664 million in bonuses in 2012, the most recent year that figures are available, to roughly 170,000 primary care practitioners, awarding each an average of $3,938, according to a <a target=\"_blank\" rel=\"nofollow\" href=\"http:\/\/www.medpac.gov\/documents\/reports\/chapter-5-per-beneficiary-payment-for-primary-care-(june-2014-report).pdf?sfvrsn=2\">2014 report<\/a> by the Medicare Payment Advisory Commission.<\/p>\n<p>Although that may sound like a small adjustment, it can be important to a primary care practice, says Dr. Wanda Filer, president of the American Academy of Family Physicians. &#8220;It&#8217;s not so much about the salary as it&#8217;s about the practice expense,&#8221; she explains. &#8220;Family medicine runs on very small margins, and sometimes on negative margins if they&#8217;re paying for electronic health records, for example. Every few thousand makes a difference.&#8221;<\/p>\n<p>Doctors in family medicine, internal medicine and geriatrics <a target=\"_blank\" rel=\"nofollow\" href=\"https:\/\/www.cms.gov\/Medicare\/Medicare-Fee-for-Service-Payment\/PhysicianFeeSched\/Downloads\/PCIP-2012-Payments.pdf\">are eligible for the bonuses<\/a>, as are nurse practitioners and physician assistants.<\/p>\n<p>Medicare generally pays lower fees for primary care visits to evaluate and coordinate patients&#8217; care than for procedures that specialists perform. The difference is reflected in physician salaries. Half of primary care physicians made less than $241,000 in 2014, while for specialists the halfway mark was $412,000, according to the Medical Group Management Association&#8217;s <a target=\"_blank\" rel=\"nofollow\" href=\"http:\/\/www.mgma.com\/about\/mgma-press-room\/press-releases\/2015\/primary-care-physicians-outpace-specialists-in-2014-according-to-mgma-physicians-compensation-repor\">annual provider compensation survey<\/a>.<\/p>\n<p>The effect the bonus program is larger on practices with more Medicare patients. Dr. Andy Lazris estimates 90 percent of the patients that his <a target=\"_blank\" rel=\"nofollow\" href=\"http:\/\/www.personalphysiciancare.net\/\">five-practitioner practice<\/a> in Columbia, Md., treats are on Medicare.<\/p>\n<p>&#8220;When the bonus payments started, it was a pretty big deal for us,&#8221; Lazris says. The extra $85,000 they received annually allowed them to hire two people to deal with the administrative requirements for being part of an <a target=\"_blank\" rel=\"nofollow\" href=\"http:\/\/khn.org\/news\/are-medicare-acos-working-experts-disagree\/\">accountable care organization<\/a> and to help the practice incorporate two new Medicare programs related to managing patients&#8217; chronic diseases or overseeing their moves from a medical facility to home.<\/p>\n<p>Next year, if they can&#8217;t make up the lost bonus money by <a target=\"_blank\" rel=\"nofollow\" href=\"http:\/\/www.npr.org\/sections\/health-shots\/2015\/05\/11\/405955775\/family-doctors-who-do-more-save-more\">providing more services<\/a>, it&#8217;ll mean a pay cut of $17,000 per practitioner, Lazris says.<\/p>\n<p>The incentive program was an effort to address shortcomings in Medicare&#8217;s system of paying providers mostly a la carte for services, which tends to undervalue primary care providers&#8217; ongoing role in coordinating patients&#8217; care.<\/p>\n<p>The expiration of the Medicare incentive program comes on the heels of a <a target=\"_blank\" rel=\"nofollow\" href=\"https:\/\/www.acpservices.org\/sites\/default\/files\/shared\/documents\/leadership-day\/14\/briefing-materials\/expiring_payment_policies.pdf\">similar bonus program<\/a> for Medicaid primary care services that ended in 2014, says Dr. Wayne J. Riley, president of the American College of Physicians, a professional organization for internists.<\/p>\n<p>&#8220;There will be some physicians who say they can&#8217;t take any more Medicare patients,&#8221; Riley predicts.<\/p>\n<p>An attorney for an advocacy group for Medicare beneficiaries says they support the bonus payments and hope physicians won&#8217;t shut them out.<\/p>\n<p>&#8220;We don&#8217;t have any evidence to show that primary care docs will stop seeing Medicare beneficiaries without the payment bump,&#8221; says David Lipschutz, a senior policy attorney at the Center for Medicare Advocacy.<\/p>\n<p>The vast majority of nonpediatrician primary care doctors accept patients who are covered by Medicare, according to a <a target=\"_blank\" rel=\"nofollow\" href=\"http:\/\/kff.org\/medicare\/issue-brief\/primary-care-physicians-accepting-medicare-a-snapshot\/\">national survey<\/a> by the Commonwealth Fund and the Kaiser Family Foundation. But while 93 percent take Medicare, a smaller percentage, 72 percent, accept new Medicare patients. [Kaiser Health News is an editorially independent program of the nonprofit Kaiser Family Foundation.]<\/p>\n<p>Not all primary care practitioners will miss the incentive program, according to the Commonwealth\/KFF <a target=\"_blank\" rel=\"nofollow\" href=\"https:\/\/kaiserfamilyfoundation.files.wordpress.com\/2015\/06\/experiences-and-attitudes-of-primary-care-providers-under-the-first-year-of-aca-coverage-expansion.pdf\">survey<\/a>.<\/p>\n<p>Only a quarter of those surveyed said they received a bonus payment; half didn&#8217;t know the program existed.<\/p>\n<p>Of physicians who were aware of and received Medicare bonus payments, 37 percent said it made a small difference in their ability to serve their Medicare patients, and 5 percent said it made a big difference. However, nearly half\u201448 percent\u2014said it made no difference at all.<\/p>\n<p><em>This entry passed through the Full-Text RSS service &#8211; if this is your content and you&#8217;re reading it on someone else&#8217;s site, please read the FAQ at fivefilters.org\/content-only\/faq.php#publishers.<\/em><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[20],"tags":[],"class_list":["post-5789","post","type-post","status-publish","format-standard","hentry","category-health"],"_links":{"self":[{"href":"https:\/\/associatednews.info\/content\/wp-json\/wp\/v2\/posts\/5789","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/associatednews.info\/content\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/associatednews.info\/content\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/associatednews.info\/content\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/associatednews.info\/content\/wp-json\/wp\/v2\/comments?post=5789"}],"version-history":[{"count":0,"href":"https:\/\/associatednews.info\/content\/wp-json\/wp\/v2\/posts\/5789\/revisions"}],"wp:attachment":[{"href":"https:\/\/associatednews.info\/content\/wp-json\/wp\/v2\/media?parent=5789"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/associatednews.info\/content\/wp-json\/wp\/v2\/categories?post=5789"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/associatednews.info\/content\/wp-json\/wp\/v2\/tags?post=5789"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}