A Financial Model of the 100% Medicare Practice

Abstract

Payment & Practice Management| June 2023 A Financial Model of the 100% Medicare Practice Johnathan Pregler, MD, FASA; Johnathan Pregler, MD, FASA Search for other works by this author on: This Site PubMed Google Scholar Mahesh Vaidyanathan, MD, MBA; Mahesh Vaidyanathan, MD, MBA Search for other works by this author on: This Site PubMed Google Scholar David S. Larsen, MD, FASA; David S. Larsen, MD, FASA Search for other works by this author on: This Site PubMed Google Scholar Michael C. Lewis, MD, FASA; Michael C. Lewis, MD, FASA Search for other works by this author on: This Site PubMed Google Scholar Elmer Choi, MD, PhD, MBA, FASA; Elmer Choi, MD, PhD, MBA, FASA Search for other works by this author on: This Site PubMed Google Scholar Christopher J. Young, MD, FASA; Christopher J. Young, MD, FASA Search for other works by this author on: This Site PubMed Google Scholar Stephen E. Comess, BSN, MHSA Stephen E. Comess, BSN, MHSA Search for other works by this author on: This Site PubMed Google Scholar ASA Monitor June 2023, Vol. 87, 1–6. https://doi.org/10.1097/01.ASM.0000938772.47169.77 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn Email Cite Icon Cite Get Permissions Search Site Citation Johnathan Pregler, Mahesh Vaidyanathan, David S. Larsen, Michael C. Lewis, Elmer Choi, Christopher J. Young, Stephen E. Comess; A Financial Model of the 100% Medicare Practice. ASA Monitor 2023; 87:1–6 doi: https://doi.org/10.1097/01.ASM.0000938772.47169.77 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll PublicationsASA Monitor Search Advanced Search Topics: medicare, economics What are the implications of a single-payer health system in which private insurance would be eliminated and practice finances would be solely based on Medicare as it exists today. This paradigm would be a unique and especially problematic issue for anesthesiologists. Presently, the profession is faced by an inimitable discrepancy in the Medicare payments for anesthesia services. This is known as the “33% Problem.” While Medicare reimbursement payments for other specialties represent between 75% and 85% of their commercial rates, compensation for anesthesia services is less than one-third of commercial rates. In fact, recently it has been concluded by some that actual Medicare payments are probably in the mid-20% range. If this was the universal payment system, it would introduce a significant threat to the long-term stability of most anesthesiology practices. Many groups address the compensation “shortfall” described above by negotiating to fill the revenue gap with payments from hospitals.... You do not currently have access to this content.