On Nov. 2, CMS released the 2024 Physician Fee Schedule Final Rule, which updated the conversion factor to $32.74, a 3.4% decrease compared to last year.
This rule has sparked discontent among spine and orthopedic surgeons since it was proposed, as reimbursement rates were already unfavorable. In combination with rising overhead costs and inflation, it created a perfect storm.
"I believe this will accelerate current trends," Harel Deutsch, MD, co-director of the Rush Spine Center in Chicago told Becker's. "Physicians in private practice will not be able to sustain a practice treating Medicare patients. There will be decreased access to care for Medicare patients and generally more treatment through nurse practitioners and physician assistants."
Declining reimbursement rates are frustrating for physicians across specialties. But what makes them even more frustrating is the feeling of powerlessness and the lack of control over the rates themselves.
"We all appropriately complain about reimbursement, but I don't think we collectively do anything about it," Chester Donnally, MD, a spine surgeon at Texas Spine Consultants in Dallas, told Becker's. "Part of the reason we don't do anything about it is we simply don't have much guidance of where to unite. Local level? State? National? It would be great if I knew which PAC or leadership group is the best bang for our buck."
However, physicians are not completely powerless. They can do things to mitigate the effects of declining reimbursements by increasing revenue.
"There are a few innovative ways that I believe spine practices can increase their revenue," Philip Schneider, MD, an orthopedic surgeon at the Centers for Advanced Orthopaedics in Bethesda, Md., told Becker's. "One way is through supporting legislation to tie Medicare rates to the Medicare Economic Index. Practices can also enhance income by expanding traditional and innovative physical therapy offerings, such as concussion programs, occupational medicine programs and/or work hardening programs. Finally, at my practice, we are looking at expanding pain management in the office to include procedures previously done in the ambulatory surgery center, which can lead to higher reimbursement rates."