Congress fails docs with sequestration


An aura of disappointment hangs heavy over the whole of healthcare in the wake of Congress’ decision to sanction across-the-board sequestration cuts — a dastardly side effect of the Budget Control Act.

Particularly jarring to the livelihood of family physicians — who are inadvertently influenced by Medicare rates — the congressional allowance forces upon providers a choice many organizations are calling inexcusable: To save a practice or a patient?

“Sequestration will slash thousands of dollars from family physicians’ practice revenue,” wrote Jeffrey Cain, MD, president of the American Academy of Family Physicians, in response to the ruling. “Because private insurers base their payments on Medicare rates, family physicians will see a domino effect as private insurance payment reflects the cuts imposed by the sequester. As small businesses operating on a razor-thin margin, family physicians will face a stark choice between putting their practices at risk or reducing the number of elderly and disabled patients they can see. Rather than rein in costs, sequestration payment cuts to health care providers will reduce access to needed care, increase the risk that preventable health conditions will develop or will worsen, and increase the chance that patients will ultimately require more intensive and expensive care. Meanwhile, the cuts likely will encourage other providers to shift costs to private payers or patients.”

The impending susceptibility doesn’t just prod at paychecks and patient dockets — it also detriments physician education grants and medical programs aimed at helping underserved communities.

Cain continued: “Sequestration even more severely cuts funding for health professions grants under Title VII, a program that focuses on primary care medical education programs; the National Health Service Corps, which encourages students to go into primary care and practice in underserved areas; and the Agency for Healthcare Research and Quality, which generates the evidence necessary to build a high-quality, high-value health care system. Cuts to graduate medical education funding will have a disproportionately negative impact on primary care physician residency training as teaching hospitals shift their limited number of training positions from primary care to more lucrative subspecialties.”

And Cain wasn’t the only physician leader dubbing the decision a failure; Jeremy A. Lazarus, MD, president of the American Medical Association (AMA), also decried rout and rupture at the acts of the legislature.

“Our lawmakers have failed to act, and Medicare patients and physicians will now feel real pain in the form of new cuts that come at an already difficult time for the nation's economy,” Lazarus wrote. “The across-the-board cut will hit physicians particularly hard because of the fundamentally flawed Medicare physician payment system. Since 2001 Medicare payments for physician services have only increased by four percent, while the cost of caring for patients has gone up by more than 20 percent. A two percent cut widens the already enormous gap between what Medicare pays and the actual cost of caring for seniors.”

MGMA-ACMPE President Susan L. Turney, MD, MS, FACMPE, FACP, chided Congress for its shortsighted vision as well.

“MGMA is disappointed in Congress’s failure to prevent across-the-board sequestration cuts, which will impact payments to physicians and compound the already dire situation for medical group practices caused by the sustainable growth rate (SGR) formula,” said Turney in a prepared statement. “This arbitrary and formulaic approach destabilizes Medicare at a time when Congress should be focused on implementing policies to achieve a high performing patient centered program.”

All organization heads agreed that more cuts would spell out disaster for the furthering of healthcare — a more balanced approach and reproach was vied for by each institution.

“We urge Congress to seek a responsible, comprehensive deficit reduction package that reverses the Medicare sequestration cuts and repeals the SGR once and for all,” concluded Turney on behalf of MGMA-ACMPE.

“The AAFP calls on both Congress and the White House to come together to find a balanced approach that will avoid these devastating payment reductions and these harmful and arbitrary cuts to programs that are so important to family medicine,” Cain similarly remarked.

Click hereafter for the full statements from the AMA and the AAFP.