Wednesday, September 15, 2010

Is private practice Cardiology dying?

I spent this weekend in Washington DC at the American College of Cardiology's Board of Governors and Legislative Conferences. Many topics of discussion, but I''ll leave the SGR and some other advocacy issues for another time.

For now, I just want to reflect on changes in private practice Cardiology which have been exploding over the past year in response to two significant cuts in physician reimbursement from CMS. First, were cuts specific to Cardiology based on the flawed practice cost survey that CMS used (illegally) to establish the 2010 Payment Schedule, and second the 38% cut in reimbursement for SPECT stress imgaging. The ACC surveyed over 6,000 practices with a response rate of about 1/3 and found that approximately one half of practices were:
  • Cutting staff
  • Reducing wages and benefits
  • Merged, or in talks to merge with hospitals
Resulting from this, thousands of people have lost their jobs (nurses, support staff, nuclear technicians) and practices are selling the assets and closing to become hospital employees. Worse yet, conference attendees told me stories about a not-so-far-past consolidation wave when hundreds of practices were bought by a couple of complanies looking to synergize by creating mega-groups across states. They offered great compensation packages, reasonable value for capital investments (real estate, equipment, etc.). But after the first rounds of contracts ended, renewal contracts were a fraction of the offers, physicians opted out and the companies went bankrupt.

Where is all this headed?

Read more detail on the ACC's blog.

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