CMS has just released the proposed physician feel schedule. You can access it here.
We haven't had the chance to read through it in detail, but a few top line items:
- Proposed cut of 6.1% for physician services to take effect January 1, 2011
- Enactment of serveral provisions of the health reform law
- Expansion of the multiple procedure payment reduction for imaging procedures
- Disclosure requirements for in-office ancillary services exception
I am sure there will be more of interest. We will read through the rule in the coming days and post a more comprehensive analysis.
Yesteday representatives of the Community Oncology Alliance (COA) were on Capitol Hill making the case for how reform, and ongoing issues with the SGR are inegatively mpacting medical oncology. These two articles (here and here) sum up the argument succinctly. They put forth some pretty frightening numbers, particularly related to the reduction in payments for the administration of chemotherapy services - 47% in real terms since 2004, such that they pay for only 57% of the cost of services.
Do the data tell the full story?
Notably, these data conflict with data from a benchmarking survey of medical oncologists publishe
d last year in the Journal of Oncology Practice. The authors have been tracking private practice medical oncologists' finances for a number of years and had seen indications in 2007 that costs might exceed revenues, but in the following year found that practice finances have held on. That doesn't mean that medical oncologists are not under financial pressure - they are, particularly in some markets, but it is not clear that situation is as dire as the COA data would have you think. Undoubtedly margins are tighter then in the past, but incomes have not come down as much as we would have expected. According to the MGMA the median medical oncologist compensation in 2006 was $362,930 and $373,037 in 2008 - so income is actually up. And data recent published in Health Affairs indicate the reason incomes are holding is when payments decline, utilization goes up. And it's precisely because of this phenomena that many are looking to clinical pathways as a means to align incentives in medical oncology (see our research on care standardization
for more information.)
Medical Oncologists Raise Alarm About Impact of Reform on Patient Access
A member recently emailed us asking for data on medical physicist salaries. Strangely, this data point is tracke by many of the usual sources we use to track salaries, so we did some digging and I thought I'd share what we found. Neither of these is an ideal source of data, so if you know of something better, please let us know.
According to this site, salaries for dosimterists are as follows (as of November 2009):
25th percentile: $82,453
50th percentile: $89,976
75th percentile: $98,153
We couldn't find as clean data for physicists, what we did find is below;
Chicago, IL $126,426
Houston, TX $82,846
Phoenix, AZ $88,265
Dallas, TX $89,641
Atlanta, GA $130,112
Charlotte, NC $126,665
Orlando, FL $113,561
Indianapolis, IN $91,751
Miami, FL $130,597
Cincinnati, OH $113,783