Small physician practices can expect 'real changes' in healthcare under Obama budget

Healthcare reform, as proposed under the Obama administration, will bring some 'real changes' for small physician practices, according to Nydia Velázquez, chairman of the House Committee on Small Business.

Velázquez spoke during a hearing last week to examine the impact the president's fiscal year 2010 budget. Physicians testifying at the hearing hope the president's proposal translates into fair Medicare reimbursement.

"Small medical providers – who are the core of our healthcare system – will also have a critical role in reform efforts. Small businesses make up nearly 70 percent of all healthcare practices, and they recognize that the current system is simply not working," Velázquez said. "These are the entrepreneurs who will be implementing change, and they are the people spearheading the process."    

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Joseph M. Heyman, MD, chairman of the American Medical Association's Board of Trustees, said the AMA is pleased with the administration’s proposed new baseline – or projected spending over a period of time – or Medicare physician payment updates.

"Unlike previous budget forecasts, the administration’s new budget baseline recognizes that Congress needs to and will act to avert the serious access crisis that looms as physicians face drastic payment cuts in the coming decade due to the failed Medicare physician payment formula," he said. "The AMA strongly supports the use of a realistic baseline as a foundation for Congress to move forward with a permanent solution to the flawed SGR physician payment formula, and urges the committee and Congress to ensure that a new Medicare physician payment baseline is adopted in the 2010 Fiscal Year (FY) Budget Resolution."

Jeffrey Harris, president of the American College of Physicians, said Obama's budget recommendation to provide funding for additional Medicare payments for physicians over the next 10 years is a good one, and will help physicians stay in practice. On Jan. 21, 2010, physicians face a 21 percent Medicare payment decrease, unless Congress intervenes to avert the cut.

"This uncertainty in Medicare reimbursement rates makes it nearly impossible for physicians to plan their budgets for their practices," Harris said.

In his budget proposal to Congress last month, Obama asked Congress for $76.8 billion for the Department of Health and Human Services for fiscal year 2010. Some funding would come from changes to the way healthcare is provided, with a new emphasis on pay-for-performance for Medicare providers.

Under the president's budget request, Medicare Advantage would be revamped, physicians and hospitals could expect to be paid for performance under Medicare, pharmaceutical companies would face steeper competition from generic drug companies and the government would clamp down on inadvertent and fraudulent overpayments under Medicare. The budget also calls for "comprehensive, but fiscally responsible" reforms to the physician payment formula, moving toward rewarding doctors for efficient quality care.

Obama said in a recent meeting with Congressional leaders that he hopes to engage in "a healthy debate going forward" over the budget, and will soon be delivering more numbers to Congress that will make the discussion "even tougher." He encouraged proposals and improvements from both Democrats and Republicans, but alluded to his impatience with partisan deadlocks.