By Julie Rovner for NPR Health
Published February 16th, 2012
The good news for the nation's doctors — and the millions of Medicare patients they care for — is that assuming everything goes as planned, the 27.4 percent cut in reimbursements that would have taken effect March 1 won't.
The bad news? The fix included in the deal to extend the payroll tax holiday isn't permanent. It only extends to the end of the year.
And then, if Congress doesn't act again, the cut it is expected to be well in the neighborhood of 32 percent.
That's leaving doctors in a continuing state of uncertainty.
"Disgruntled is probably just too soft of a term for this," says Robert Wah, a reproductive endocrinologist at the National Institutes of Health and the Walter Reed Army Medical Center. He's also Chairman of the Board of Trustees of the American Medical Association. "It's really devastating to try to run an office in this environment."
Wah says doctors have been through this exercise before — waiting to see if Congress will stop a scheduled Medicare cut. Too many times.
"In 2010, Congress did this to us five times," he said. "There were five patches put in place, and a couple of times they actually waited until after the deadline," which meant payments were delayed.
Wah says many physicians are also small businesses. So the uncertainty of knowing how much — or in some cases whether they're going to be paid to see their Medicare patients, is more than just an inconvenience. "Because they have to continue to pay their rent and their insurance and their electric bill and the salaries of the people that work in their office," he says.
Until now, the public hasn't had a lot of sympathy for the plight of America's doctors and their Medicare woes. Despite their complaints, doctors still earn a lot more than the average American. And surveys showed that most doctors continued to treat Medicare patients.
This problem with how Medicare pays doctors is the result of a funding formula enacted in 1997 that's since gone awry. It affects many members of the military, too, because rates for the TRICARE health program are tied to those for Medicare.
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