The median earnings for cardiologists was slightly lower in 2011 than 2010, falling from $325,000 to $314,000, according to the most recent installation of an annual Medscape survey on physician compensation. Cardiologists ranked third among the 25 specialties surveyed, trailing only radiologists and orthopedic surgeons. However, despite their high ranking, the number of cardiologists who felt they were fairly compensated remained low at 46%, among the lowest in the survey.
Cardiologists see slight pay decline in 2011
On Tuesday CMS issued its inpatient prospective payment system (IPPS) proposed rule for fiscal year (FY) 2013, which would increase Medicare operating payments to acute-care hospitals by 0.9% after accounting for various policies in the proposed rule and projected utilization of inpatient services.
Under the proposed rule, general acute care hospitals participating in the Hospital Inpatient Quality Reporting program will see payment rates increase by 2.3% which accounts for inflation, productivity improvements, a statutory adjustment factor, and adjustments for documentation and coding changes. Those that do not participate would receive a 2.0% reduction, or an overall payment rate update of 0.3%.
The proposed rule affects about 3,400 acute care facilities and it is expected to increase acute care hospital payments by $175 million in FY 2013 compared to FY 2012.
Impact of 2013 IPPS proposed rule on CV services
Though in FY 2013 the Readmissions Reduction Program targets three conditions (heart failure, pneumonia, and AMI), it has the potential to expand to four additional conditions in 2015. These conditions—identified in the 2007 MedPAC Report to Congress—were deemed to be the most common and costly sources of readmissions. One of those conditions is percutaneous coronary intervention (PCI), identified in 2007 to cost the U.S. $359 million in 15-day readmissions. Already, the National Quality Forum has endorsed PCI readmissions as a measure of hospital performance. As such, several articles have recently been published in the literature examining the frequency and reasons for readmissions associated with PCI in an effort to provide guidance on how hospitals can begin to inflect these rates.
Last week, Robert Yeh and colleagues reported the outcomes of their investigation in the online edition of Circulation: Cardiovascular Interventions. The authors found that risk-standardized all-cause 30-day readmission rates after PCI varied significantly across hospitals and that few readmissions could be traced back to the level of quality provided at individual hospitals. These findings might suggest that few readmissions are in hospitals’ control or could be reduced, even with concerted efforts to address them.
Examining PCI readmissions: Causes too undetermined to hold hospitals accountable?