Last month, the Centers for Medicare & Medicaid Services (CMS) proposed a rule that will cut Medicare payments for nearly all surgical procedures starting January 1, 2021. In some cases, surgeons will see up to 9% reductions in reimbursement for care. Cutting payments means less money for university medical centers like mine that fund critical clinical research, and now is hardly the time to be cutting money for medical research.
Academic hospitals are the backbone of the medical community. In addition to caring for patients, our hospitals provide education, mentoring, training, and a host of other essential services that don’t wind up on a balance sheet at the end of the year.
Every year, CMS makes cuts to Medicare payments that have a very substantial impact on our day-to-day operations, making it more difficult to deliver care to our patients and provide high-level education to medical students, residents, fellows, and researchers. However, this year, the problem is compounded by the severe economic crisis brought on by COVID-19.
I’m an ophthalmologist, and our hospital shut our office to non-emergency procedures from March to May as part of COVID-19 precautions. Doing so was the right thing to do to protect patients and stop the spread of the virus. It also allowed surgeons and other health care workers to redeploy to hard-hit areas. I worked through virtual urgent care units to help patients in New York, New Jersey, and Florida, helping to free my colleagues on the frontlines to triage patients and respond to the surge of coronavirus patients. But the financial repercussions have been devastating on our already small-margin business. The hospital as a whole is facing a financial impact of over $200 million due to COVID-19.
Weill Cornell Medicine Ophthalmology runs research programs from macular degeneration, cataracts, and glaucoma to neurological disorders, but insurances plans – Medicare included – do not reimburse that work. The resources we need to conduct research and publish papers is funded by the revenue we generate through routine visits and surgical procedures, as well as philanthropy and awarded grants. Government grants and philanthropy are both likely to be decreased due to the combination of COVID-19 and the resulting economic downturn, so any cuts to Medicare payments will directly impact our ability to do potentially vision-saving research. The same is true for the research and development system nationwide; a recent analysis predicted that total research funding will drop 20-40% due to COVID-19. Government should be addressing this shortfall, not compounding it.
I became a doctor to help people. I work as hard as I can to protect people’s sight and find ways to prevent, manage, and even cure vision-threatening conditions. It’s why I continue to do research to improve my patients’ lives and prepare my students to be the best possible health care providers they can be. This is why the government’s cuts to Medicare are so demoralizing. It hurts our ability to train the next generation of surgeons and find the next generation of medical breakthroughs.
Fortunately, there is a solution. Congress needs to step up and take action to prevent these cuts from taking effect in January. Our health care workers have already sacrificed so much to get us through this crisis, and it’s clear that now is not the time to reduce funding for critical surgical services.
The Surgical Care Coalition is working to stop these cuts. Find out more at surgicalcare.org.
Christopher Starr, MD, FACS, AAO is an Associate Professor of Ophthalmology at Weill Cornell Medicine.