It’s not fair

“I can’t believe Medicare won’t pay me for complications in the post op period.  It is just not fair.”

Recently, I shipped a package to my son who works at a financial company near the World Trade Center site.  When he received it, he texted me a picture of the package, so I’d know it had arrived. (Oh youth).  To my surprise, the package had a sticker on it that said, “X-rayed by Pitney Bowes.”  X-rayed, of course, because he works at a financial company, with a clear view of the new WTC building.    When I spoke with him, I said, “I didn’t know Pitney-Bowes did anything else besides postage meters.”  He replied, “What’s a postage meter?” (Oh youth). 

Medical practices bemoan changes in reimbursement—always lower—that make it harder for them to stay in business.  Services that were paid separately are bundled into a single payment.  Reimbursement for some diagnostic tests are set to the lower Outpatient Prospective Payment System rate.  This leaves medical practices feeling under siege.  A Podiatrist, who hadn’t started his medical training until long after the global surgical package was in effect, told me “It’s not fair that Medicare won’t pay me to treat post op complications in the office.”   Pitney-Bowes could have complained that people send fewer letters, or they could adapt to the business environment and find a new revenue line. 

It’s easy for us in medical practices to adopt that attitude, but it doesn’t help us to adapt to the new healthcare environment.  As I think about the three most critical strategies for most practices I see them as: 1) Participate in CMS incentive programs (PQRS, e-Prescribing, EMR), 2) keep up to date on coding for your field, and 3) use technology to reduce billing costs and increase billing effectiveness.     

Changes in the business environment in and out of healthcare are challenging, and sometimes seem unfair to us. But like all business, we need to adapt in order to thrive.


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s