Today's post comes to us from ACC's Advocacy Committee Chair Vincent Bufalino, M.D., F.A.C.C. In this position, Dr. Bufalino leads ACC efforts at advocating for changes to the health care system, in particular the payment system. When he isn't busy lobbying Congress, Dr. Bufalino is president and CEO of Midwest Heart Specialists in Naperville, Ill.
The cardiology community is
in frenzy over the latest insult offered by CMS. As well we should be – CMS has
proposed reducing overall Medicare payments to cardiology by 11 percent. That
overall figure is misleading – the proposed cuts to core cardiology services
range from 10 to 40 percent. It also doesn’t include the regularly scheduled
SGR cuts of more than 20 percent. The total result? Cardiology practices could
see cuts at little 25 percent (ha!) to as much as nearly 50 percent. In just
This is insanity. Cuts as
massive as these will have enormous effects on the practice of cardiology – not
just for the practices, but more importantly, for the patients. Here’s what the
cuts could mean for patients:
- Reduced access. Practices won’t be able to afford to provide
certain services to patients, which means that they’ll need to go to the
hospital to receive the care. This will require them to take extra time off
work and pay higher copays. In low-access areas, the nearest hospital could be
hours away. This just isn’t feasible for everyone. CMS may not have intended to
reduce access to much-needed cardiovascular services, but that’s just what
they’ll be doing if these cuts go through.
Staff lay-offs. With drastically reduced incomes, cardiology
practices are going to have difficulty maintaining current staffing levels.
This will have negative effects on the customer service offered to patients, as
offices try to do more with less.
Reduced quality. Cardiologists have led the way in improving
quality. Morbidity and mortality for heart disease have dropped 29 percent over the last eight years. This is because cardiologists are committed to quality. We’re
a leader in our creation of clinical documents. Not to mention our incredibly
well-developed group of registries that improves patient care. Large numbers of
us participate in the Physician Quality Report Initiative. We use electronic
health records at higher rates than other specialties. We are specialty
committed to improvement. That said, our participation in quality improvement
activities – which often require a heavy administrative burden – is threatened because
we won’t have the funds to maintain the staff needed to submit the proper
paperwork or the time to complete it. As fellow ACC member Patrick Anonick,
on this blog: “We are rapidly approaching a point where we cannot afford the
overhead to focus on these issues.”
This is serious. In my
practice, we have a group of 50 physicians covering much of suburban Chicago. If these cuts go into place it will put undue
hardship on our practice. We would have to stop hiring new physicians and begin
to shrink our staff base to maintain a stable fiscal base. It would clearly affect
on our service and stop us from doing the free community work that we have
become known for in the area. As we decrease our staff, the added extras that
have become a part of our service will just go away. Many of our smaller
counterparts will possibly have dire consequences to their longevity.
Here’s what the ACC is asking
us to do:
Call, e-mail or visit with
your lawmakers to point out the serious consequences of the proposed rule. The
ACC has talking points, patient materials and a sample letter available on www.acc.org/can. Advocacy staff (Molly Nichelson and Justin Beland) can help you schedule
appointments with your lawmakers, which will be especially effective if you
visit during the August recess when they are back in their districts.
Take part in the ACC's
"Cut the Cuts Roadshow" and volunteer to give your own or facilitate
an ACC-taped presentation on the implications of the cuts on cardiology to your
hospital or practice group. Email firstname.lastname@example.org
for more information.
Now is also the time to
give to the ACC Political Action Committee if you have
not already done so.
Attend this year’s
Legislative Conference, Sept. 13-15 in Washington,
D.C. This is a great opportunity
to help educate Congress about these effects of these cuts. Registration is
More than ever, Congress
needs to hear from us. Please leave a comment below to say what you think would
be the effects on your practice if the cuts were to go through, but make sure
you also do one of the four things listed above. As Jack said earlier this
time to roll.”
-- Vincent Bufalino, M.D., F.A.C.C.
* Dr. Bufalino’s post is
part of a monthly series of guest posts by ACC
leadership. Check back next month to see which ACC leader is sharing his or her
thoughts on health care reform!
*** Image from Flickr (Sir Twilight King). ***