In a special report on the 2003 Medicare Fee Schedule, Part B News reported that another 6 percent decrease is expected in the reimbursement for neurosurgeons’ services unless Congress acts to reverse itself.
Year after year neurosurgeons are faced with the problem of providing exceptional care for declining reimbursement. Over the past five years, across-the-board cuts have caused neurosurgeons to see as much as a 40 percent decline in income, while they are working as hard or harder than they ever have. Neurosurgeons are being paid less as they are simultaneously hit with higher costs for professional liability insurance, labor, and compliance with the ever-increasing bureaucracy. Changes related to becoming compliant with the Health Insurance Portability and Accountability Act alone have added significantly to the cost of practicing neurosurgery.
Given this economic and regulatory environment, the most tempting course of action is to board up the windows and head for greener pastures. However, these times demand exactly the opposite action. Now is the time to get creative, engage our entrepreneurial spirits, and use the enormous neurosurgery talent pool to find ways not just to survive, but to thrive.
Playing on the Same Team
There is a need to align the goals of neurosurgeons with those of their administrators and managers. Many an administrator has faced the grim consequences of being the bearer of bad news. Neurosurgeons ask, Why can’t you collect more of the money for the services I have provided? The simple answer is that there is no more to collect. Why do we need all these people to support my practice? Because to get paid, even the reduced amount, it takes far more effort. Verification, authorization, and precertification have led to an explosion of required manpower. The time for blaming messengers is over. The time to unite for a common cause is upon us.
To help us as administrators and managers of neurosurgery practices, the Council of State Neurosurgical Societies is funding an initiative to develop a professional society for the advancement of our profession. As the interim president of NERVES, I look forward to collaborating with you on its formation.
What is the mission of NERVES? First and foremost it will be a forum where we can share ideas that work for a neurosurgery practice, as well as a source of solutions to the problems we all face. Over the last 15 years as a practice administrator, my most valuable source of education has been the information shared by my peers. A creative way to deal with a staff problem; a new source of revenue that doesn’t add to the expenses; a process that not only saves money, but also makes the task easier — all of these ideas and hundreds more have been the fruits of interaction with my peers.
Neurosurgery is a specialized field. The solutions that work in a pediatric office will not work in a neurosurgery office. Neurosurgery administrators and managers need the support of others traveling the same road.
NERVES also will serve as the repository for data about the business of neurosurgery, offering a place we can turn to for valid benchmarking data so that we can properly understand the practice we are charged with stewarding. Our physicians deserve to have the peace of mind that comes from knowing their practice is functioning as well as it can in difficult times. By gathering reliable, valid data, NERVES will give us all an indispensable management tool.
Achieving Full Participation, Success
NERVES offers an exciting opportunity for gathering the resources that we need to thrive as managers. Neurosurgery itself is an exciting specialty, replete with opportunities to advance the health and well being of many people. Our physicians trust that those opportunities will be maximized through our careful management of their resources. With full participation of neurosurgery’s practice managers, NERVES will succeed.
If you are a physician reading this, I hope you will recognize the fantastic opportunity NERVES will provide to maximize your financial success and discuss this opportunity with your practice manager. For us to help you we need your support-financial support, time to attend meetings, and encouragement to be involved. Alone we can each accomplish a great deal, but together we are unstoppable.
Mark Mason is interim president of NERVES and practice administrator at Neurological Surgeons PC in Nashville, Tenn.