MMA News Now
MMA Ramps Up Efforts on Medicare Payments
In November, the MMA stepped up its efforts to stop a 23 percent Medicare payment cut from taking place this month by urging members to contact their representatives. It also released findings from a survey of members about whether Medicare’s instability was harming their ability to provide care to seniors.
In October and November, the MMA asked 2,046 members whether the constant threat of payment cuts followed by Congress’s stop-gap measures to prevent them from happening had caused them to limit their Medicare case load. The survey also asked physicians what effect a 23 percent cut in Medicare payments would have on their practice.
About one-quarter of the 135 respondents said they had placed limits on accepting Medicare patients during the last two years. About 8 percent said they had closed their practice to new Medicare patients during that same period.
In addition, about 27 percent of physicians said they would close their practice to new Medicare patients if a 23 percent cut took effect, and about 12 percent said they would be forced to stop treating existing Medicare patients.
In addition, the survey showed that the government’s failure to adequately fund health care for seniors is resulting in costs being shifted to other patients. About 38 percent of the physicians who responded reported that they had increased the fees charged to other patients to make up for the losses they take on treating Medicare patients. About half of those respondents said the funding instability has hampered their clinic’s ability to purchase new equipment.
The MMA issued the press release about the survey’s findings the week Congress reconvened for its lame-duck session in November.
The MMA also called on physicians to ask their lawmakers to stop the cut, and about 150 physicians responded. In addition, the MMA encouraged doctors to participate in the AMA’s “White Coat Wednesday,” an effort to get physicians across the country to call members of Congress on November 17 and urge them to pass an 11-month funding fix.
For years, Congress has failed to deal with the Medicare payment formula, called the Sustainable Growth Rate (SGR) formula. Each year, this formula generates a cut in Medicare payments to clinics and physicians, despite the fact that practice costs rise. Although lawmakers have acknowledged that this formula is flawed, Congress has been unwilling to find the money needed to permanently fix it.
“Congress has been trifling with the health care of seniors for several years, and it is taking a toll on the ability of Minnesota seniors to get access to physicians,” says MMA President Patricia Lindholm, M.D.
Throughout 2010, Congress enacted stop-gap measures for durations as short as one month to stop or reverse steep cuts caused by the SGR formula. However, on three occasions, Congress failed to act in time, causing Medicare payments to physicians and clinics to be cut by more than 20 percent until another temporary fix took place.
This cycle forced a number of practices across the country to seek loans to meet payroll expenses, lay off staff, or cancel capital improvements and investments in electronic health records and other technology, according to the American Medical Association. When payments resumed, many physicians experienced long delays in receiving retroactive adjustments.
MEDPAC Scores High Win Rate
Eighty-five percent of candidates endorsed by MEDPAC, the MMA’s political action committee, won their seats in the November election.
MEDPAC endorses candidates whose positions on issues are most aligned with those of the MMA, regardless of their political affiliation. This year, MEDPAC representatives asked candidates about their position on the state budget deficit, health care safety net funding, reimbursement rates for physicians, increasing the tobacco tax, investments in public health, and tort reform. MEDPAC historically has had a strong record on the campaign trail, with its endorsed candidates winning up to 90 percent of the time.
In house races across the state, MEDPAC endorsed 21 DFL and 13 Republican candidates. In the state senate races, MEDPAC endorsed 14 Democrats and nine Republicans. MEDPAC endorsed independent Tom Horner in the governor’s race.
MEDPAC is an independent organization, but it serves as the political arm of the MMA.
Republicans Take Control of Legislature
Following the November election, during which Republicans took control of both chambers of the Minnesota Legislature for the first time since 1974, the MMA responded by calling on Republican and DFL lawmakers to work together to continue Minnesota’s health care reform efforts and to mend the state’s frayed health care safety net.
The MMA sent out a statement to the media in which MMA President Patricia Lindholm, M.D., said, “The voters have spoken, and we stand ready to work with the new majorities in both bodies and with whoever is finally elected governor. We want to congratulate Republican lawmakers on their victories, and we look forward to working with them like we did in 2008, when Minnesota passed a bipartisan health care reform act.”
Republicans now control the Senate by a 37 to 30 margin and the House 72 to 62. Republican majorities in the House and Senate may give new life to ideas such as reducing or repealing the sick tax, replacing MinnesotaCare with vouchers, offering tax deductions to individuals to help them purchase health insurance, allowing the sale of insurance across state lines, reducing the number of state insurance mandates, and providing consumers with information about the cost and quality of health care.
It is also likely that the Republicans will target health care programs in order to close a projected $6 billion budget gap. Republican leaders have been clear that tax increases are not part of their agenda. During the campaign, Republican gubernatorial candidate Tom Emmer proposed a budget that included a $2.25 billion cut to Minnesota’s health care safety net and no increase in taxes.
As a result, the future of the General Assistance Medical Care (GAMC) program remains unclear. The MMA supports transferring GAMC enrollees to Medical Assistance as part of an early Medicaid option that would result in Minnesota receiving about $1.46 billion in federal funds in exchange for an investment of $188 million. The next governor has until January 15 to accept the federal funds. However, because of the looming recount in the governor’s race, it is unclear who will be in office when it is time to make that decision.
DFL candidate Mark Dayton, who currently leads the race, has promised to enact the expansion; Republican Tom Emmer has said he will not. Gov. Tim Pawlenty will continue to serve as governor until the election is decided. He declined the federal Medicaid dollars earlier this year.
Dave Renner, the MMA’s director of state and federal legislation, says that the political landscape in Minnesota has changed but that the reality of the state’s budget deficit remains.
The message from the MMA is still the same, he says: that the physicians of Minnesota want Republican and DFL lawmakers to work together and take a balanced approach to resolving the state’s deficit. “We’re hoping that they can find common ground in areas such as reforming our health care system, increasing the tobacco fee, and maximizing federal dollars,” Renner says.
Minnesota Medicine Recognized for Excellence
Minnesota Medicine, the monthly periodical of the MMA, won multiple awards from the Minnesota Magazine and Publishing Association (MMPA) last month. The magazine won:
- A silver award for overall excellence; A gold award for the best how-to article —“Building a Home” (January 2010);
- A gold award for the best single cover—April 2010 (Help for Haiti);
- A silver award for the best technical article—“Outwitting HIV” (October 2009);
- A bronze award for the best feature article—“The Hidden Toll of Abuse” (August 2009); and
- A bronze award for the best single-topic issue—The Historians (March 2010).
The MMPA’s Excellence Awards recognize superior achievement for editorial work, design, and overall excellence. Receiving Minnesota Medicine is one of the benefits of being an MMA member.