Neurosurgeons Predict Services Cuts if Medicare Reimbursements Are Cut

More than half of neurosurgeons in a national survey say they will cut services and time spent with Medicare patients if Congress doesn't act to permanently fix the sustainable growth rate formula, and prevent the 21.5% reimbursement cuts that are scheduled to go into effect on March 1.

The online survey also found that nearly 40% of the of 678 neurosurgeons who responded said they would decrease the number of Medicare patients they see, and more than 18% said they would no longer take new Medicare patients.

"These results really do paint a bleak path we are going down. Many neurosurgeons in our survey indicated that if Medicare payments continue to decline, they would stop providing certain services, reduce staff, defer purchase of new medical equipment, reduce time spent with Medicare patients, and begin referring complex cases elsewhere," said Troy M. Tippett, MD, president of the American Association of Neurosurgical Surgeons, one of three neurosurgical associations that sponsored of the survey. "It is crucial that Congress pass legislation immediately to address the decline in Medicare payments so that we can alter this course."

Tippett said neurosurgeons do not support the annual temporary "doctor's fix" that will only make it more costly to repeal the SGR in the future.

The survey found that neurosurgeons have seen changes in Medicare that have made it less patient friendly in the past five years. Most notably:

• It has gotten harder to refer patients to certain medical and surgical specialists (67.2%).


• More physicians are referring Medicare patients with complex problems to other doctors (64.8%).


• Medicare patients now have to travel further to get needed care (63.7%).


• Neurosurgeons are reducing the number of Medicare patients in their practice because of low reimbursement (59.2%).


• The average waiting time for a patient appointment is 24.1 days for new patients and 19.5 days for established patients.


• Neurosurgeons who limit the number of Medicare appointment slots do so through the scheduling process (42%), by limiting the overall number of Medicare patients they treat (35%), or by selecting patients based on their geographic location (10%).

Survey results also show that not all U.S. geographic locations are alike. Medicare patients in the Southwest face more difficulties in finding neurosurgeons. When compared to the national average, the Northwest and Northeast quadrants appear to be a bit more stable.

The survey was conducted by Perception Solutions in September, and has a 5% margin of error. The survey was sponsored by the AANS, the Congress of Neurological Surgeons, and the Council of State Neurosurgical Societies, which combined represent about 7,600 neurosurgeons.