AMA President Cecil Wilson, MD, Wednesday wrote in his blog (On the Road with Dr. Wilson) about the changing cardiology landscape, citing the results of ACC’s 2010 Practice Census. The survey found that more than half of all practices have taken some form of cost-cutting action as a direct result of the cuts in reimbursement for cardiovascular services included in the 2010 Medicare Physician Fee Schedule over the last year. In addition, nearly 40% of cardiology practices are integrating with hospitals or merging with other practices, and 13% are considering it.

Wilson writes:

“So where does that leave patients, you might ask? In the hospital – that’s where. Patients are being pushed to hospitals to get the care and the serves they need. But with the costs of procedures much higher in the hospital setting, patients are left with higher co-pays, longer turnaround in treatment and increased costs.”

He’s right. CMS’ attempt to cut costs to private practices is only going to lead to higher costs in Part A (how hospitals get paid through Medicare) and more inconvenience and cost to patients. It’s misguided, and it’s good for no one except hospitals – not even CMS itself.

The current situation is a prime example of why we need a reformed payment system. We’re not ever going to be able to meaningfully cut costs in our current trajectory. We need a payment system that will encourage high-quality, cost effective care. Until we get that, we’re going to see the slow demise of the private practice of cardiology, and more and more patients being pushed into hospitals, whether they want to be there or not.

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