Home From The Editor Shifting finances: the shape of things to come?

Shifting finances: the shape of things to come?

Published in the January 2010 issue of Today’s Hospitalist

2010 IS SHAPING UP to be an interesting year for hospitalists in terms of reimbursement.

Hospitalists are finding themselves at the center of attempts by Medicare to make health care more efficient by changing how physicians are paid. A good example is the planned elimination of consult codes, which is featured in this month’s cover story.

As I write this, Medicare appears to be sticking to its plans to drop consult codes, effective Jan. 1. There’s been furious speculation about whether the government might delay or cancel the change, but at press time, at least, we’ve heard no word about any change of plans.

Even if the Centers for Medicare and Medicaid Services does put the brakes on eliminating consult codes, many experts expect the move to be temporary. Medicare stands to save a significant amount of money from deleting these codes, funds that may be used to pay for primary care services instead.

And whatever happens with consult codes, one thing is certain: Medicare is sure to continue tinkering with health care financing, in part to make payments to primary care physicians more robust.

Medicare’s proposal to bundle payments to hospitals and physicians is another example. The goal is to encourage physicians and hospitals to work together more effectively to improve care “and possibly reduce costs.

The jury is still out on whether bundled payments will help or hurt hospitalists, but one concern is starting to sound familiar: Medicare might try to take any savings from bundled payments and shift them to primary care.

While bundled payments aren’t expected to be introduced this year, they serve as a reminder that big changes in reimbursement are coming, some possibly in 2010. On that note, I’ll wish you a Happy New Year.

edoyleEdward Doyle
Editor & Publisher
edoyle@todayshospitalist.com