Survey Results Show Elimination of Consultation Codes Negatively Affects Delivery of Physician Services
The elimination of Medicare’s consultation codes (except for telehealth services) effective January 1, 2010, has had a negative impact on physician efforts to improve care coordination and reduced the treatment options available to Medicare patients, according to new survey results released July 16, 2010 by the American Medical Association (AMA).
In April, the Heart Rhythm Society partnered with the AMA and 16 other medical specialty societies to develop a survey to understand and quantify how CMS’ policy is affecting physicians (learn more). Approximately 5,500 physicians completed the survey, results of which revealed that many practices have taken a number of cost-cutting steps to offset revenue losses associated with elimination of the consultation codes.
Survey Highlights
- Three out of every ten (30 percent) have already reduced their services to Medicare patients or are contemplating cost-cutting steps that will impact care
- One-fifth (20 percent) have already eliminated or reduced appointments for new Medicare patients
- Nearly two-fifths (39 percent) will defer the purchase of new equipment and/or information technology
- More than one-third (34 percent) are eliminating staff, including physicians in some cases
- Following CMS’s suggestions that they no longer need to provide primary care physicians with a written report, approximately 6 percent have stopped providing these reports, while nearly another one-fifth (19 percent) plan to stop providing them
After analyzing the survey data (PDF, 78K), AMA and association/society representatives identified several technical improvements that would make the policy more equitable. They joined with 16 other organizations in a letter outlining their concerns and asking the Centers for Medicare and Medicaid Services (CMS) to review and modify its current policy to prevent further deterioration of care coordination between physicians. Read the comment letter (PDF, 22K), which concludes:
"A review of CMS’s current policies regarding physician consultations is clearly called for. Revenue losses for consultant physicians are larger than projected. Physicians have been forced to reduce services to Medicare patients and care coordination has suffered as a result of the policy. These problems could be mitigated by revising CMS guidelines regarding prolonged visits and new patients and/or by creating some mechanism for reimbursing consultant physicians for a comprehensive report back to a referring physician. We ask that CMS confirm in its proposed Medicare Physician Fee Schedule Rule for 2011 that it will address this issue in the final rule..."
The Heart Rhythm Society will continue to advocate for modifications to CMS’ policy to recognize consultative level services provided by electrophysiologists. If you have any questions, please contact Lisa Miller-Jones, Director of Reimbursement and Regulatory Affairs at LMiller-Jones@HRSonline.org.
Visit the AMA website to learn more and to review full survey results (PDF, 78K).
