As a surgeon practicing medicine in my home town of Beverly, MA, I know how important private practice physicians are to small towns across this county. Unfortunately, the Centers for Medicare & Medicaid Services (CMS) is getting ready to devastate patient care in this country by slashing Medicare payments for nearly all surgical specialties starting in 2021.
According to new rates announced by the CMS on August 4th, Medicare reimbursements for surgical care will be cut by as much as 9% despite rising industry costs and an ongoing financial crisis. The result is that financial pressures—intense already and made worse by COVID-19—are set to intensify and become unsustainable.
The only way to protect our surgeons and their communities is for Congress to waive Medicare’s budget neutrality requirement and stop these cuts from going into effect, before thousands of surgeons across the country shutter their practices.
Running a surgical practice is the same as running a small business, and these practices have high fixed costs with a great deal of overhead. We invest in new equipment, employ highly trained staff, and rent facilities to perform complex procedures. The expenses of running a surgical practice climb between one percent and four percent annually.
This CMS rule forces surgeons to run faster just to stay in the same place.
These surgeries are complicated and intense procedures. A laparoscopic cholecystectomy, for example, is a procedure to remove a gallbladder that takes anywhere from 45 minutes to more than three hours for complex cases. It’s an operation where one mistake—particularly affecting the liver’s drainage system—can have permanent consequences. For that lengthy surgery today, we are lucky if CMS reimburses surgeons in Massachusetts $700, with the reimbursement hovering closer to $560 due to the deductible. And it is set to be decreased.
Those costs will be borne by myself and the three other surgeons I work with, who perform collectively roughly 2,000 surgeries in an average year. They will be felt by the physician’s assistant and nurse practitioner we employ who work tirelessly for our patients. And should our practice have to close down, they will be endured by the entire community of Beverly as thousands lose access to high quality and most importantly local care. Beverly will not be the only community to suffer this loss of access; a nationwide survey found that one-in-three private practice surgeons are already considering closing their practice due to financial pressures.
The Surgical Care Coalition has formed to stop these cuts from taking effect because they will hurt patients’ access to quality care. To prevent these cuts and preserve care for patients, the SCC wants Congress to waive Medicare’s budget neutrality requirements, which will ensure Medicare patients continue to have the best access—to the best care—when they need it and where they need it.
Beverly is my home. It is where I’ve lived and practiced as a surgeon for the last 15 years after attending medical school on a Navy scholarship. While I want to practice here in Beverly until I retire, I might not get to realize that dream because of these massive cuts to Medicare payments. And my neighbors and loved ones will lose access to yet another small practice, making it more difficult to get the quality health care they deserve.