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    July Medicare pay cut takes top priority at urology advocacy conference

    Urologists warn legislators of effects of 10.6% reduction


    Bob Gatty
    Washington—Against a backdrop of impending reductions in Medicare fees and warnings that a funding crisis looms, urology professionals from across America descended on Capitol Hill recently, determined to stand up for themselves and their profession.

    It was the third annual Urology Joint Advocacy Conference, co-sponsored by AUA, the American Association of Clinical Urologists, and UROPAC, during which urologists met face to face with congressmen and senators. Their goal: Help lawmakers understand the importance of urology and the need for fair treatment for physicians when it comes to government policies that affect their practices and patients.

    "Overall, this year's advocacy conference was extremely successful," said Beth Kosiak, PhD, AUA's associate executive director for health policy. "Our members were energized and confident that they could make a difference, even though important change in Washington often takes time."

    That often frustrating reality certainly is evident with respect to Medicare reimbursement, as Congress has been forced to step in and prevent scheduled reductions each year for the past 511/42 years because of the sustainable growth rate (SGR) system used to calculate annual payment updates. Now, Congress must act again if a 10.6% cut scheduled for July 1 and an additional 15.6% cut for 2009 are to be prevented.

    Fast Facts
    For the past several years, AUA and other medical organizations have urged Congress to replace the SGR system with one that pays Medicare physicians on the basis of the true costs of furnishing health care services to beneficiaries. The Medicare Payment Advisory Commission (MedPAC) has also recommended reform.

    "The point is that physicians are suffering," Dr. Kosiak said. "They shouldn't be sustaining repeated cuts like this. Every other provider group, like hospitals or nursing homes, is paid according to an inflation-adjusted index. Doctors should be paid that way as well."

    AUA members told congressmen and senators that if the 10.6% cut takes effect in July, the typical urology practice of four urologists could suffer revenue losses exceeding $200,000.

    Such a loss "would make it very difficult for a urologist to see additional Medicare patients, to take additional charity care, to purchase health information technology equipment, to participate in an e-prescribing program, or to comply with quality measurement reporting initiatives," an AUA briefing paper explains. "Such a severe loss in revenue over the next 6 months could force these small business owners to lay off employees or to take early retirement for themselves."

    Fifty-one percent of the average urologist's patient income is generated from Medicare, according to AUA. This number will increase as baby boomers enter the system in 2011, when 44 million Americans become eligible. Another 40 million will enter the system in 2016.

    "They will be part of a system where practice costs are increasing at a rate of 2% a year, while revenue is falling," AUA cautions. "As a result, if no action is taken now to fix it, the system will simply not be able to accommodate their needs."

    Just after urologists completed the Advocacy Conference on April 1, Senate Finance Committee Chair Max Baucus (D-MT), indicated he will send a bill addressing the scheduled cuts and other Medicare issues to the Senate floor rather than running it through his committee.

    AMA has been supporting the Save Medicare Act of 2008 introduced by Sen. Debbie Stabenow (D-MI) in March, which would continue the 0.5% pay update approved for the first 6 months of the year through year's end, and then provide a 1.8% increase for 2009.


    Bob Gatty
    Bob Gatty, a former congressional aide, covers news from Washington for Urology Times.