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The year 2007 was successful for cataract surgery; many developments in technology and pharmaceuticals provided benefits to surgeons and their patients, and others to come promise even better things to come. Only the ongoing story of fee reductions from Medicare seems able to temper the positive outlook of cataract surgeons.
The 2008 Medicare physician fee schedule final rule released by the Centers for Medicare & Medicaid Services Nov. 1 included a 10.1% reduction in the conversion factor for physician-related services, which was required by law under the sustainable growth rate formula. Dr. Olson characterized the cut as "pretty scary" and said that such reductions can continue for a limited time only.
"Everybody recognizes that the volume-adjusting system in place is seriously flawed. The problem with a fix, however, is that it makes the long-term prognosticators show even worse budgetary challenges, and nobody wants to admit that. So we all continue to play a game, except the game is real, and ophthalmologists, along with other physicians, are the ones getting hurt," he said.
Ophthalmologists are suffering more than other specialties, he said, because they are being hit simultaneously with a decrease in the multiplier and in fees for core procedures.
Dr. Olson predicted that the only chances that the situation will change involve a new administration taking over at the next election or a "crunch time" in physician services forced by the fee reductions.
"Either the next administration will try to balance the budget a little better or it will reach the point at which masses of physicians decide they can no longer see Medicare patients," he said.
The AARP and American Medical Association have joined forces to lobby legislators to stop Medicare physician payment cuts and preserve senior citizens' access to health care. Dr. Olson said he hopes that, together, the two groups will have the political muscle to influence a change.
"It is going to take that kind of power alliance or large numbers of physicians refusing to accept Medicare patients to get this problem resolved," he told Ophthalmology Times.