Outlook 2015: Physicians

Physicians face large possible Medicare pay cuts, implementation of the ICD-10 coding system, which they generally dislike, and having federal quality reporting programs switch from financial rewards to penalties.

With primary care seen as the foundation of population health-based care models, healthcare systems will continue their buying spree to hire primary-care doctors. Indeed, physician recruiters say primary-care doctors are in high demand. Doctors also are being called on to fill new leadership roles to manage change.

For 2015, the CMS has established a new $42.60 monthly payment for non-face-to-face care-management activities to coordinate care for Medicare patients with multiple chronic conditions. But doctors are wary of whether the administrative burdens of collecting the payment will outweigh the benefits. The American Medical Group Association said it will survey its members to find out whether the new fee is helping to improve care or adding to administrative burdens.

Congress as usual is expected to stave off the 21% Medicare pay cut scheduled to take effect April 1 under the sustainable growth-rate formula. But lawmakers are not expected to extend the Patient Protection and Affordable Care Act provision that temporarily boosted Medicaid primary-care fees to match Medicare levels. An Urban Institute study estimated that primary-care doctors face an average 42.8% decrease in Medicaid fees, which may affect their willingness to see low-income patients.

“This cut in Medicaid payment may result in having less access to physicians in their offices and push patients to be seen in the more costly emergency room,” Dr. Robert Wergin, American Academy of Family Physicians president, said in a news release.

It remains unclear whether Congress and the Obama administration will be able to agree on legislation to repeal and replace the SGR formula, particularly how to offset the $140 billion, 10-year price tag.

Follow Andis Robeznieks on Twitter: @MHARobeznieks