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Deep Cuts to Medicare Rates: Why You Should Care

image of a diagram of medicare | GI NorthFew would argue that budget cuts are necessary, but where exactly to make those cuts is vastly complex. For several years now, the Centers for Medicare and Medicaid Services (CMS) has been making cuts in an effort to avoid over payment as required by the Affordable Care Act. And while reducing overpayment sounds beneficial, the consequences often outweigh the savings.

In 2015, CMS proposed drastic cuts to reimbursement rates for colonoscopy and other lower GI endoscopy procedures. As you can imagine, there was much resistance to these cuts, but in the end, many of the proposed cuts were made cutting reimbursement for some codes as high as -16%.

These reductions focused on services provided in physician offices and freestanding facilities, which leaves hospitals to perform the procedures at the previous reimbursement rate. And, in some cases, rates were increased for hospital procedures.

At this point you might be wondering why you should care, and the truth is because these cuts could impact the quality of care available to you, as well as your choice of providers. Now in 2016, the physicians that perform colonoscopy are receiving up to 19% less for the procedure. This reduction in reimbursement will pose a challenge for physicians to continue to perform this life saving procedure.

Colon cancer is the third most common cancer in the U.S., and a colonoscopy is the most effective way of detecting and treating pre-cancer growths. Gastroenterologists are specialized in performing colonoscopy having a more focused training in comparison to a proctologist, yet gastroenterologists are the group of physicians directly affected by the cuts. Research continuously shows that gastroenterologists are less likely to miss potential concerns and less likely to undergo complications such as perforations.

Additionally, the National Colorectal Cancer Roundtable (NCCR) set a goal to increase screening rates for colorectal cancer to 80% by 2018, which could prevent 277,000 new cases of cancer and 203,000 deaths. While the NCCR has been making strides, reaching that goal with these new cuts poses a serious challenge since availability of screening facilities may decrease.

Every American after the age of 50 should undergo a screening for colon cancer every 10 years and many before that if high risk, so the question is who do want in charge of saving your life?

For those in the Atlanta area, GI North Gastroenterology Services offers excellent, specialized care with personalized attention. GI North is still accepting Medicare and performing quality colonoscopies. So if you are over 50 or carry one of the risk factors for developing colon cancer, contact our office. GI North is conveniently located in Cumming and serves the areas of Alpharetta, Roswell, Canton, and Suwanee. Dr. Cofrancesco and Dr. Quijano, who speaks fluent Spanish, are available to assist you with any gastroenterological need.

© 2016 GI North Gastroenterology Services. All rights reserved.


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