CMS SQUEEZE Under the new fee schedule, ophthalmic surgeons would see a 6% reduction in reimbursements.

Surgeons and anesthesiologists are speaking out against slashes made to surgical service reimbursements in the Centers for Medicare & Medicaid Services' proposed 2021 Physician Fee Schedule. The new rule will result in these significant reductions in Medicare payments if the current draft takes effect on Jan. 1:

• 9% for cardiac surgery
• 8% for thoracic surgery
• 8% for anesthesiology
• 7% for vascular surgery, general surgery and neurosurgery
• 6% for ophthalmic surgery
• 5% for orthopedic surgery

The Surgical Care Coalition, a recently formed group of 12 surgical professional associations, spoke out this week against the proposed fee schedule, which it says jeopardizes surgical care.

"The middle of a pandemic is no time for cuts to any form of health care, yet this proposed rule moves ahead as if nothing has changed," says David B. Hoyt, MD, FACS, executive director of the American College of Surgeons, a founding member of the Surgical Care Coalition. "The healthcare system cannot absorb cuts of this magnitude. The Surgical Care Coalition believes no physician should see payment cuts that will reduce patients' access to care."

The Coalition says that the cuts were even harsher than expected, dealing an extra blow to the many surgeons whose businesses took major hits when elective surgeries were banned earlier this year. "The policy was ill-informed and dangerous to patients even before the pandemic started, but could be even more detrimental as our healthcare system continues to weaken under COVID-19," states the group. "This rule will likely force surgeons to take fewer Medicare patients, leading to longer wait times and reduced access to care for older Americans."

The American Society of Anesthesiologists says it has been actively engaged in working to convince CMS of the negative implications of cuts to physician fees, which it says cannot withstand decreases that do not recognize the threat that COVID-19 brings to the economic viability of medical practices.

Joseph A. Bosco III, MD, FAAOS, president of the American Academy of Orthopedic Surgeons, also expressed disappointment in the proposed cuts. "Devaluing the time and effort that orthopedic surgeons spend prioritizing value-based care communicates a larger plan by the agency to gradually reduce the value of these procedures," says Dr. Bosco. "Worsening the financial strain on [surgeons'] practices, at a time when they have been disproportionately affected by COVID-19 federal guidelines to delay care, will have a severe and lasting impact on American seniors' access to life-improving surgeries."

Dr. Bosco says AAOS is urging CMS to reconsider the significant preoperative work that is required to make value-based care both cost-effective and high-quality, and to refrain from finalizing these punitive cuts on the value of orthopedic care.