Physician Reimbursement Mostly Flat or in Decline

Following a trend since at least 2001, physician reimbursement for existing patient visits was mostly flat in 2013, it declined in all categories of new patient visits.

Last year reimbursement for new and existing patient visits declined or remained flat, according to the annual survey from Physicians Practice.

Physician reimbursement pay is following a trend since at least 2001 of flat or declining reimbursements. The annual Fee Schedule Survey found that for existing patient visits reimbursements were relatively flat, but declined in all categories of new patient visits.

The highest complexity code (99205) used by practices saw a 21% decrease in reimbursement pay.

"Year after year, physicians and their practices are receiving less pay for the same amount of work," Keith L. Martin, Physician Practice's group editorial director, said in a statement. "So physicians — like any other profession facing this dilemma — are looking for ways to change the way they do business without compromising patient care."

Some of the ways physicians are looking to boost revenue is through partnerships with other physicians and health systems to develop Accountable Care Organizations, participate in pay-for-performance programs or create patient-centered medical homes.

According to the survey, a quarter (27%) of physician respondents expect to receive between 11% and 25% of their revenue through some format other than fee-for-service reimbursement. And 18% said they expect to receive more than 50% of their revenue through non-fee-for-service contracts.

Unfortunately, a third of physicians are still unsure how a shift in payment methodology will affect them and their practices — 23% said a shift will be neither good nor bad; 26% said it will be bad and just 16% said it will be good for their practices.

"With a number of options and programs to choose from, it can be hard for practices to make a choice that best fits them," said Martin. "Our goal is to help practices look at each option and provide expert advice on conducting some due diligence before signing on the dotted line."

The survey used data from more than 2,500 medical practices in the country. Responding practices were spread out fairly equally across regions of the country and were mostly small practices with five or fewer physicians (64%). A third were primary care practices while 22% reported being a medical specialty.