Daniel Charytonowicz retweetledi
Medicare is cutting payments to proceduralists because surveys suggest we have become more “efficient.”
Under the Physician Fee Schedule, payment is tied to estimated physician work inputs. It’s the Marxist labor theory of value in federal policy.
If CMS concludes that a procedure now takes less time or effort, the RVUs are reduced. Time and effort are treated as proxies for worth.
Yes your doctor gets paid less for being more efficient.
We are treating older and sicker patients. Documentation requirements have exploded and admin burden has grown. Total professional effort has not meaningfully declined.
And even if operative time truly falls, why does that automatically justify a pay cut?
In a functioning market, if a plumber or mechanic becomes more efficient, he keeps the surplus unless competition drives prices down. Price reflects supply and demand, not a central estimate of minutes spent.
Medicare does not operate that way. Payment is periodically reset by formula. If your innovation reduces operative time, the system eventually claws back much of the gain through revaluation.
Basic economics still applies. Lower administered prices reduce expected returns. Over time that affects specialty choice, training pipeline decisions, capital investment, and willingness to adopt new technologies. Supply responses in medicine are slow because training is long and capital is sticky, but they are real.
You cannot repeatedly cut prices and assume supply and innovation remain unchanged.
Medical Economics@MedEconomics
Medicare’s new “efficiency” adjustment = another physician pay cut. Sally C. Pipes & Mike Koriwchak, M.D., argue rising practice costs + more clerical work don’t equal real efficiency. Read the commentary: hubs.li/Q043TvnY0 #MedicalEconomics
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