Less Money, More Rules for US Physicians in 2015

Megan Brooks

January 02, 2015

The new year has ushered in multiple changes in the business of medicine in the United States, many hitting physicians' pocketbooks.

For example, for the many physicians caring for Medicaid patients, 2015 means a return to the old reimbursement rates, as pay increases under the Affordable Care Act that bumped reimbursement 40% or more in 2013 and 2014 expire.

"The Medicaid cuts are going to have an important impact on family physicians, particularly those who have increased the number of Medicaid beneficiaries in response to the parity with Medicare payment," Robert Wergin, MD, president of the American Academy of Family Physicians, told Forbes January 1.

However, 15 states have said they will continue paying at the higher rate using their own funds, while others are still deciding the matter, according to a survey by the Kaiser Family Foundation reported by Medscape Medical News.

Medicaid is not the only area in which physicians will see reimbursement shrink. Several Medicare cost and quality measurements and mandates, courtesy of the Centers for Medicare & Medicaid Services (CMS), that will likely reduce payments will kick in this year.

It's something that worries the American Medical Association (AMA). In a statement issued back in October, the AMA warned the CMS about the "regulatory tsunami" facing US physicians that could cut Medicare payments by more than 13% by the end of the decade.

Meaningful Use Penalties

US physicians will also have to face the music on "meaningful use" of electronic health records (EHRs).

On December 17, the CMS announced that the Medicare program will penalize more than 257,000 physicians and other healthcare providers 1% of their pay next year for failing to achieve meaningful use of EHR technology in previous years.

Reacting to the news, Steven Stack, MD, the AMA's president-elect, said in a statement, "The AMA is appalled by news from CMS today that more than 50% of eligible professionals will face penalties under the meaningful use program in 2015, a number that is even worse than we anticipated."

At its interim annual meeting in November, the AMA House of Delegates adopted a resolution urging CMS to suspend all meaningful use penalties, saying the requirements established by CMS are too tough to meet for most physicians.


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