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AMA to The Florida Times Union: Missing the Point

Sept. 30, 2011(published)

The Florida Times Union
Letter to the Editor

To the Editor:

The editorial, "Why primary care is undervalued," missed the real issue: Payments for all physician services in Medicare are so low that they threaten patients' continued access to care from all types of physicians, not just those in primary care.

There is already a 20 percent gap between Medicare payment updates and physicians' practice costs, and physicians now face a massive cut of nearly 30 percent on Jan. 1 from the broken Medicare physician payment formula unless Congress acts.

One in five physicians, and nearly one-third of primary care physicians, say they are already forced to limit the number of Medicare patients in their practice due to the ongoing threat of cuts and inadequate Medicare rates. This failed formula limits Medicare patients' access to physicians and prevents investments in new models of care that increase coordination and reduce costs. It must be repealed.

Contrary to the claim in the editorial, the AMA-convened panel of physicians known as the RUC makes recommendations on the value of specific physician services based on the resources they require - like time, equipment, training and staff assistance.

Medicare payments for services often performed by primary care physicians have increased 20 percent since 2006 due in part to recommendations from the RUC. The RUC has made recommendations on other services frequently performed by primary care physicians, which Medicare's decision-makers have elected not to pay.

The congressional deficit committee has a unique opportunity now to stop the real threat to Medicare by repealing the broken physician payment formula before it imposes a nearly 30 percent cut on Jan.

Peter W. Carmel, MD
President, American Medical Association