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N.Y.C. Council speaker calls on Mayor Eric Adams to resign; KY could do more to protect kids from accidental drug ingestion, shootings; OH food banks face fed funding uncertainty, DeWine budget cuts; Protesters say Trump administration actions 'cast aside democracy.'

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On a Middle East visit, Sen. Richard Blumenthal rejects a Gaza takeover. President's Day protests erupt around the country against White House moves, and another aviation accident draws attention to recent FAA cuts.

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Rural America struggles with opioids and homelessness in unexpected ways, Colorado's Lariat Ditch could help spur local recreation, and book deliveries revive rural communities hit by Hurricane Helene.

Medicare cuts threaten private medical practices, access to care in NC

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Friday, September 27, 2024   

Physicians in North Carolina are warning that what they describe as Medicare's outdated payment system is putting patient care on the line, especially in rural communities.

For years, Dr. Sreejit Nair's practice, Sunrise Vascular, has provided specialized vascular treatments to patients who would otherwise need to travel hours for care. Now, because of ongoing Medicare cuts, Nair said he fears without immediate reform, his patients and many others in underserved areas could lose access to life-saving treatments.

"It's already too late for many practices," he said, "and there are a few of us that are still trying to hang on for dear life, trying to still provide these desperately needed services to areas of the country where there's no other option."

The problem stems from Medicare's Physician Fee Schedule, which has slashed payments to lower-cost private practices such as Dr. Nair's, while increasing them for higher-cost hospital-based services. The imbalance is pushing many private practices to the brink of closure, leaving patients with fewer options for affordable care.

The Office-Based Facility Association is advocating for reforms to pull high-cost supplies and equipment out of the fees currently covered, and create a new payment model for office-based providers.

Jason McKitrick, the association's executive director, said these changes would still reimburse for these supplies, and be the lifeline for these smaller medical practices.

"Over the last few decades, as the technology advances have allowed those services to move from the hospital to the office-based setting," he said, "the money hasn't gone with it."

He said Medicare's own data show what is reimbursed today doesn't cover the direct cost of care or doctor's salaries for at least 300 office-based services.

McKitrick stressed that without these reforms, the burden will also fall on patients, who'll have to seek more expensive care.

"When these centers shut down, they have to go to a higher-cost site of service - and in many states, the only other option is a hospital," he said, "and so, they're paying up to five times more for some services."

He said this affects patients who need all types of care, from physical therapy to oncology and even cardiac surgery. He suggested that prompt legislative action is critical.

Disclosure: Office-Based Facility Association contributes to our fund for reporting on Consumer Issues, Health Issues, Mental Health. If you would like to help support news in the public interest, click here.


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