SAN FRANCISCO, Dec. 12 /PRNewswire/ -- The Californian Medical Assn.
voiced support Wednesday for Blue Shield's decision to maintain current
reimbursement rates for physicians in the face of Medicare's plan to impose a
5.4% fee cut for 2002.
Calling Blue Shield "a good partner," CMA officials said the nonprofit
health plan had taken an important step by not putting more fiscal pressure on
physicians who already face rising costs and unrealistic reimbursements.
"You can't provide health care without physicians, and the economics of
health care in California is forcing medical groups to close their doors and
physicians to leave practice," said Dr. Frank E. Staggers, Sr., president of
the CMA. "This step is a significant one by a major health plan. It
recognizes that physicians are already stretched," said Dr. Staggers, an
No health plan other than Blue Shield has announced its rate structure for
2002. However, many typically link their rates to the Medicare rate structure
or use it as a benchmark, and that could cause a ripple effect, said CMA
At the same time, CMA officials said maintaining reimbursement at current
levels is not a long-term solution. Expenses continue to rise for medical
practices. The Medical Group Management Assn. reported expenses increased
6.2% for the average multi-specialty physician group in 2000.
Dr. Staggers said CMA is carefully watching the for-profit health plans to
see if these insurance companies cut rates for physicians, and then send the
money on to their shareholders and executives.
The Centers for Medicare and Medicaid Services (formerly HCFA) last month
announced a 5.4% cut in outpatient reimbursements for physicians, which will
take effect Jan. 1. Legislation has been introduced to limit the cut to 0.9%.
The Medicare payment rates are driven by a statutory formula that uses
non-medical based cost indicators, such as the Gross Domestic Product (GDP),
to update payment rates. These indicators are rising more slowly than the
indices that track the cost of delivering medical care. In addition, the
Department of Health and Human Services has made errors in the formula used to
compute the rates. Because the formula is cumulative, errors made in the
first two years that were never corrected are compounded with each year's
The California Medical Association represents 35,000 physicians in all
specialties and modes of practice. It is one of the nation's largest state
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SOURCE California Medical Association