10% cut to reimbursements for many procedures

[RustedFox]

They are, it's just for PLPs.

5 million to teach the NPs how to shop online during their shift.

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[vm26]

The Consolidated Appropriations Act of 2021, which passed through the Senate with my support, includes $3 billion to increase payments under the Medicare Physician Fee Schedule while suspending the implementation GPC1X add-on code, boosting payments to physicians and professionals for all services by 3.75 percent throughout 2021 and mitigating the Centers for Medicare and Medicaid Services’ proposed cuts.

I'm guessing the 3.75% increase is across the board so if your specialty was getting an increase, they are now getting a bit more and if your specialty was getting cuts, these cuts are decreased to a certain extent

 

[southerndoc]

I think what I saw (but have not verified) was the EM basically zeroed out.

 

[vm26]

Is that the final rule? 4%?

I saw on auntminnie somebody posted there would be a freeze for the 2021 year but wasn't able to find any sources. Not like it matters anyway. I'm on the edge of my seat watching to see if there's gonna be anything left of this profession by the time I'm an attending, but it may be better for my mental health to just check out like the majority of my colleagues. Ignorance truly is bliss.

-4% is what I got from the ACR. I'm assuming that there will be a similar if not larger cuts for 2022. I know it sound pathetic but this was a "victory" primarily bc we worked with other specialties as a coalition. NPs/PAs are much more united.

I felt the same way you do now back around 2010. Many of my academic attendings viewed CMS cuts as a private practice issue and thus were not engaged. Some co-residents and attendings were pro-active (eg. took the 30 sec it takes to send the pre-written email to their representatives) while many were just not tuned in for whatever reason. Not too much discussion about this even on Auntminnie. I recommend doing what you can and then moving forward (easier said than done but something to strive for).

I'm pretty cynical when it comes to politics, but seeing all the "pork" in this bill was surprising and likely the norm. It's amazing how politicians can wine about deficits etc and then spend huge sums of money on a vast array of BS.

Our HC system is dysfunctional and expensive (though I was surprised that we only outspent Switzerland by 5% in relation to gross domestic product in 2018). I'm also pretty sure we spent a little more on military and foreign aid. I'm not smart enough to know what the solution is. System seems to always be on the brink of implosion but never happens (yet).

Regardless of how bad things seem to get, keep in mind that you are way ahead of a huge chunk of the population (US and global).

 

[vm26]

5 million to teach the NPs how to shop online during their shift.

Great news for medmal lawyers provided that NPs can get sued and be subjected to expert testimony from a physician

 

[zero0]

-4% is what I got from the ACR. I'm assuming that there will be a similar if not larger cuts for 2022. I know it sound pathetic but this was a "victory" primarily bc we worked with other specialties as a coalition. NPs/PAs are much more united.

I felt the same way you do now back around 2010. Many of my academic attendings viewed CMS cuts as a private practice issue and thus were not engaged. Some co-residents and attendings were pro-active (eg. took the 30 sec it takes to send the pre-written email to their representatives) while many were just not tuned in for whatever reason. Not too much discussion about this even on Auntminnie. I recommend doing what you can and then moving forward (easier said than done but something to strive for).

I'm pretty cynical when it comes to politics, but seeing all the "pork" in this bill was surprising and likely the norm. It's amazing how politicians can wine about deficits etc and then spend huge sums of money on a vast array of BS.

Our HC system is dysfunctional and expensive (though I was surprised that we only outspent Switzerland by 5% in relation to gross domestic product in 2018). I'm also pretty sure we spent a little more on military and foreign aid. I'm not smart enough to know what the solution is. System seems to always be on the brink of implosion but never happens (yet).

Regardless of how bad things seem to get, keep in mind that you are way ahead of a huge chunk of the population (US and global).

IDK I've pretty much lost hope at this point. I've written my representatives. I've done the song and dance. But seems like all it amounts to is to delay the inevitable for another year, if even that. We're powerless. Might as well accept it and save your coronaries the added stress.

The only thing I could see working is a physician union, but that won't happen.

 

[vm26]

IDK I've pretty much lost hope at this point. I've written my representatives. I've done the song and dance. But seems like all it amounts to is to delay the inevitable for another year, if even that. We're powerless. Might as well accept it and save your coronaries the added stress.

The only thing I could see working is a physician union, but that won't happen.

I hear you and feel your pain. It's disheartening to be in a field (rads and medicine) where on can expect to work more for less.

After having spoken to a few of my older colleagues about the current state of affairs this is my take: With respect to CMS cuts, the next 2 years will make or break non-EM fields like Rads, EM, Anesthesia, critical care etc. I am going to renew my ACR membership and continue to donate to RADPAC for the next 2 years. If we still get scr*wed then I'm done with the ACR (and go get a job with the VA)...I would suggest that you (and anyone in any of these fields) do the same. I know membership to ACR (and equivalent groups is not cheap) but donations can be relatively modest ($50-100 or whatever). Point is if everyone gave something it would add up and getting to politicians is our only play. Also encourage your colleagues. People b*tch and moan yet can't find the time/motivation to send these freakn emails or open up their wallets.

 

[nimbus]

Mid to high six figures? Uh No?

No one is making 500k-900k. In europe and canada they making more like 150k, down to 100k in UK

In Canada, it’s comparable. Maybe slightly lower than US.

GasWork.com - Reference #162126

www.gaswork.com

GasWork.com - Reference #299259

www.gaswork.com

 

[nimbus]

The evolution of work/compensation ratio will be interesting. I'm a rad not ER. I worked a call shift yesterday which was relatively light but still def over 100 RVUs for the day. I'm an associate at a relatively busy PP and make about 60% of the partners. I could not tolerate anything like this if I was making 150K/year.

In Southern California, many of our circulating nurses in the OR make $150k/year.

Lots of nurses in the Bay Area make 300-400k+ working in the public sector. VA anesthesiologists who mostly sit around from 7-3 make $300k+. I don’t think $150k for a physician is in the cards.

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