Medical Economics

Information for Medicare/Tricare patients

MEDICARE ALERT (November 2011)

Dear Patient,

WE NEED YOUR HELP!

Congress has been postponing making cuts in Medicare/Tricare payments by kicking the can down the road for the better part of the last decade, and now, as of January 2012, the proposed cuts are 27.5%.

The chances are very high that you fit into one of two categories: either you

1) have Medicare (or Tricare for military families), or

2) you know someone who has Medicare, like an older relative.

Recently, a Medicare Payment Advisory Committee (MedPAC) has made another suggestion: to freeze any reimbusement increases to practitioners for the next decade, and for specialists, to lower the reimbursement 6% a year for the first three years. Given that Medicare has been lowering the reumbursements to physicians for the last 15 years, and given that the costs of doing business continue to increase, the net effect of the MedPAC recommendations over the next decade are a greater than 27.5% net decrease in reimbursements to providers.

We really enjoy treating Medicare and Tricare patients and want to keep doing so, but we checked with our landlord, our employees, our suppliers, and our malpractice insurance carrier, and none of them will take a 27.5% discount on what we are paying them. In fact, they all want more money.

Here's the bottom line: If these changes go through, access to medical care will be severely restricted. Given the rising costs associated with running a medical practice, if these cuts go through, we will have to, as will many other doctors, stop taking new Medicare or Tricare patients.

In order to prevent this threat to access to medical care from becoming a reality, we need your help. We need you to contact your congressmen right away to express your opinions on this matter. Please call Congress today to share your thoughts in this regard. Don't ignore this issue thinking that somebody else will take care of it. Don't wait until you or your older family member can't find medical care. Please call today.

Sincerely,

The Physicians of Orthopaedic Associates.

Congressional Contact Phone Numbers:

Congressman Sanford Bishop, Albany Office (229) 439-8067, Washington DC Office (202) 225-3631

Senator Saxby Chambliss, Toll Free 800-234-4208, Washington DC Office (202) 224-3521

Senator Johnny Isakson, Atlanta Office (770) 661-0999, Washington DC Office (202) 224-3643

Also, you can contact your Federal Representatives and Senators toll free by using the AMA Grassroots Hotline at 1-800-833-6354 and entering your zip code and you will be connected to the appropriate office.

Also note that the actual percentage of medicare spending that goes to physicians is a small part of the total pie.

Source: American Academy of Orthopaedic Surgeons Research and Health Policy Departments, 2007.

MALPRACTICE REFORM ALERT, April 2010

Dear Patient,

MALPRACTICE REFORM:

An issue that will affect Georgia patients is Malpractice Reform, also called Tort Reform.

In 2005, Georgia enacted malpractice reform which allowed costs of malpractice insurance to be more in line with costs in other states that have enacted similar reforms. As a result, more doctors have chosen to practice in Georgia, which is an issue especially here in the southwest part of the state.

For physicians, the risk of a malpractice lawsuit is not evenly spread across all specialties, but is especially high for fields such as orthopedics and spine surgery, and approximately 1/3 of all orthopedic surgeons can expect to be sued in a given year. High litigation rates jeopardize our ability to provide affordable health care, and overuse of expensive tests as part of defensive medicine is a result.

Georgia has had malpractice reform in place until the week of March 22, 2010, when the Georgia Supreme Court struck down these reforms.

Here is how the court decision may affect you:

-The cost of delivering care to patients, which includes malpractice insurance, will rise, and these costs will have to be passed on to the consumers like you and your family.

-More charges will be generated as defensive medicine will be practiced more intensively.

-For those patients who have fixed reimbursements, like those on medicare and medicaid, the number of openings for patients with those types of insurance will have to be significantly limited.

-Newly trained physicians will be less likely to choose to practice in Georgia and older physicians may choose to retire sooner. Access to care will become a problem.

The physicians of Orthopaedic Associates agree that victims of medical malpractice deserve compensation, but lack of reasonable caps incentivizes lawyers to sue doctors for staggering sums under the guise of malpractice claims, regardless of whether the patients gave informed consent and received responsible, quality care.

We are not sure what the next step will be, but hope that some legislative fix can be applied so that patients don't lose access to the medical care they so deserve.

We urge you, in the meantime, to contact your state representative to express your feelings on this issue.

In order to prevent these threats to access to medical care from becoming a reality, we need your help. We need you to contact your congressmen and state representatives right away to express your opinions on this matter.

Please call Congress today for Medicare issues and the State Legislature for Malpractice Reform issues to share your thoughts in this regard. Don't ignore this issue thinking that somebody else will take care of it. Don't wait until you or your older family member can't find medical care. Please call today.

Sincerely,

The Physicians of Orthopaedic Associates.

Congressional Contact Phone Numbers for Medicare Reimbursement Issues:

Congressman Sanford Bishop, Albany Office (229) 439-8067, Washington DC Office (202) 225-3631

Senator Saxby Chambliss, Toll Free 800-234-4208, Washington DC Office (202) 224-3521

Senator Johnny Isakson, Atlanta Office (770) 661-0999, Washington DC Office (202) 224-3643

State Contact Phone Numbers for Malpractice Reform Issues:

Governor Sonny Perdue, Office of the Governor, Georgia State Capitol, Atlanta, GA 30334, Phone: 404-656-1776

Lieutenant Governor Casey Cagle, 240 State Capitol, Atlanta, GA 30334, Phone: 404-656-5030

Representative Winfred J. Dukes, 411-D Coverdell Legislative Office Building, Atlanta, GA 30334, Phone: 404-656-0127 or 920 Highland Avenue, Albany, GA 31701, Phone: 229-432-9891

Representative Bob Hanner, 512-A Coverdell Legislative Office Building, Atlanta, GA 30334, Phone: 404-656-7859 or 9610 Plains Highway, Parrott, GA 39877, Phone: 229-623-2841

Representative Ed Rynders, 401 State Capitol, Atlanta, GA 30334, Phone: 404-656-7855 or 423 Martindale Drive, Albany, GA 31721, Phone: 229-888-9928 (Office), 229-436-7455 (Home)

Senator John Dickey Crosby 324-A Coverdell Legislative Office Building, Atlanta, GA 30334, Phone: 404-463-5258 or Post Office Box 891, Tifton, GA 31793, Phone: 229-326-6780 (Cell)

Senator Freddie Powell Sims, 305 A Coverdell Legislative Office Building, Atlanta, GA 30334, Phone: 404-463-5259 or, 5377 Goose Hollow Road, Dawson, GA 31742, Phone: 229-347-0251

Patient Advocacy Action:

And, for the record, on a recent patient care issue, I was bothered by the way non-emergency transport services would leave a Medicaid patient from a nursing home in our office. Some patient transporters would bring in an older patient in on a stretcher, place them on an exam table (which has no guardrails) and then leave. The situation was not acceptable, since we have no way, aside from the stretcher which they just took away, of even getting that patient to Xray or the cast room.

I wrote a series of letters to the GA Dept. of Community Health, with carbon copies to the Governor, and finally got a response:

/Documents/Mark Trail letter0001.pdf

Mark A. Wolgin, MD Orthopaedic Surgeon

Specialist (Fellowship Trained) in Spinal and Foot/Ankle Surgery