Sunday, September 5, 2021

Medicare Pays Anesthesiologists Less Than Plumbers


American doctors may be among the highest paid physicians in the world, but that wouldn't include anesthesiologist who receive their patient reimbursements through government healthcare. 

In an interview in Becker's ASC Review, Dr. Scott Harper, Assistant Professor of the Department of Anesthesiology and Perioperative Medicine at the University of Alabama Birmingham, noted that Medicare pays anesthesiologists the equivalent of $45 an hour for their services. That's less than what your local plumber charges you to come in and look at your clogged toilet.

With new federal laws prohibiting doctors from balance billing, which is charging patients for the balance of a medical bill not fully paid for by insurance, the problem is only getting worse. Insurance companies have no incentive to reimburse doctors fairly because they don't have to deal with irate customers who have to pay out of pocket anymore. Now these companies are canceling contracts and lowering thier reimbursement rates, getting closer to Medicare rates.

Anesthesiologists already have to put with Medicare payments that are only about one third of private insurance reimbursements. Medicaid, which is government insurance for the poor and indigent, pays even less. The wide expansion of stingy Medicaid is how the Affordable Care Act aka Obamacare is able to insure millions more people, on the backs of doctors and hospitals. 

If the private insurance payments keep going lower, anesthesia private practice will be a thing of the past. We will all become hospital employees like emergency medicine or pathologists. Only hospitals will have the leverage to negotiate fair contracts with these behemoth insurance corporations. Individual anesthesiologists will not be able to sustain a viable business model with payments that rival the plumbing profession because plumbers don't have to pay back six figure student loans and five figure malpractice insurance premiums as part of their business expenses. 

14 comments:

  1. WHEN I TOLD MY ABSENT FATHER I WAS ACCEPTED TO MEDICAL SCHOOL, HE SAID" WHY DON'T YOU BE SOMTHING HONEST, LIKE A PLUMBER- LAST TIME I SPOKE TO HIM

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  2. The ultimate burden of paying anesthesiologists falls to the working class. They get charged more to compensate for the low MC reinbursement.

    The working class pays more and the retired rich guys can skip by paying less.

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    1. As an anesthesiologist "rich guy" who is about to retire I would remind you that I have been paying and will continue to pay for Medicare so NO it is not paying less. Medicare is $500 per month for my wife who just went on Medicare

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  3. Agree with the above. What we should be outraged about is the fact that health "care" in the United States is based upon a lottery determined by income, employer, state of residence. Some private insurance payments for high end procedures are outrageously lucrative, while yes, uninsured patients may struggle to pay much higher charges than Medicare rates.
    It is time for anesthesiologists to ask how we can participate in such an unethical system. Care of patients should not be based in ability to pay.

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    1. Mary,
      "Care of patients should not be based in ability to pay." So, this leads to government-paid health care, 100%. When there is nothing but federally-paid healthcare, estimate what the feds will pay you!! NOTHING but Medicare/Medicaid rates and those
      rates will decline.

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  4. MediCal (CA Medicaid) pays anesthesia even less per hour than my cleaning ladies charge!

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  5. I appreciate the angst but the answer is to stop feeding the beast. Nearly every anesthesia department in the country receives a supplement for operations and the days of private or independent practice are long gone. The sooner you accept reality, the happier you will be. Retirement can't come soon enough.

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  6. Why do we tolerate payments decreasing every year while overhead increases? Is there another industry like this?

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    Replies
    1. We tolerate this situation because doctors consider themselves above caring about money. Other professions like teachers and longshoremen have no problem denying children their education or disrupting the entire American economy to get more money. As long as doctors consider themselves martyrs then the payers will keep taking advantage of the situation.

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  7. Never blindly accept the "facts". The premise that CMS pays anesthesiologists $45/hour is fatally flawed. CMS pays ~$22.30 per 15 minutes, which equates to $89.20/hr for running time only. There is a "front load", depending on the type of case, for a number of additional units, and there are modifiers that pay in addition. Bottom line- the LEAST that an Anesthesiologist gets paid by CMS is $89.20/hr.Dr. Harper is simply factually incorrect.

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    Replies
    1. Not true. Maybe in your region, but lower in mine. Much closer to the $45 quoted than your inflated $82.90

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  8. Still depressing to see Medicare paying anesthesiologists less than $100 per hour. Medicaid pays a fraction of that. We went through years of postgrad education and hundreds of thousands of dollars in debt for THIS?

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  9. Doctors are to be pushed out and replaced by Nurse Anesthetists that will be hospital paid, organize and vote accordingly

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