CMS suggested a 3.34 percent conversion factor decrease in its proposed Medicare physician fee schedule for 2024. Two gastroenterologists connected with Becker's to discuss their thoughts on the proposal.
Note: These responses have been lightly edited for length and clarity.
Stephen Amann, MD. Gastroenterologist at Digestive Health Specialists (Tupelo, Miss.): Unfortunately, CMS continues to focus on cuts to the front-line providers for Medicare recipients. I am certainly cognizant of the general financial pressure on CMS and Medicare, but fulfilling their promises on the back of the providers is problematic. These cuts continue to undermine physician practice's ability to provide access and care to the Medicare population. Physician service payments have not come close to keeping up with inflation for years. Indeed, physician payments via Medicare are one of the only areas in Medicare payment models that does not have inflationary adjustments and has had frequent cuts.The staff, equipment and supplies we have in an office practice have continued to go up and are affected by inflation as is everything generally in society.
My biggest concern over time is that this will begin to erode access for Medicare recipients to find physicians who will continue to accept new patients or will limit the number of patients from Medicare that they will see. The financial strain on practices will erode development of new services, expansion of care and may influence decisions to join an employment type of practice.
Physicians in private practice, despite these cuts, over time have generally improved and expanded the number of patients they serve and take care of due to diligent work, efficiency and innovation. Unfortunately, these financial constraints may ultimately negatively impact our ability to continue to practice as we know it.
Sheldon Taub, MD. Gastroenterologist at Jupiter (Fla.) Medical Center: People wonder why our healthcare system is in such a turmoil. Poor access to doctors, and emergency rooms are so overcrowded with trivial problems. Who wants to go into medicine when your reimbursement goes down every year? I pay more for my plumber or electrician than I make per hour. Also, the restrictions are becoming unbearable. And don't forget the underlying fear of malpractice. Our healthcare system is a travesty, and I have to blame much of it on the government. Big business is running medicine and that's a shame.