Medicare offered its "Final Rule" for its 2009 Physician Fee Schedule for doctors recently. To see how this "Rule" applies to heart rhythm specialists is virtually impossible, thanks to the layers upon layers terms and specifications unique to only those who deal in such machinations. Here are a few such terms:
Is there any wonder that the guys who do the work are completely and utterly baffled by such a payment system? In every instance, the system obfuscates and confuses while supporting it's own network of highly-paid sycophants to decipher the hieroglyphics.
- "CMS will continue using the “bottom-up” methodology to calculate Practice Expense RVUs."
- "Practice Expense RVUs are calculated on the basis of a blend of RVUs"
- "Harvard-valued codes"
- "anti-markup rules"
- "work GPCI floor"
- And don't forget the "PE Database"
What an absolute and utter mess our system of physician payment has become. Even specialist societies, have to "continue to review the final rule and provide rate analysis of the impact on EP (electrophysiology) services in the weeks to come." (emphasis mine)
Most of us already know what the Robin Hoods of bureaucracy are going to do: steal from the rich (specialists) and give to the poor (generalists). After all, that's what "budget neutrality" is all about. But it's much easier to plug a number in to a computer formula than speak with people.
That's how people in the back boweries of government who don't deal directly with people work.