resident's Message

September 2023

Dear Florida Chapter Members,

Did you know that reimbursement on CV procedures through Medicare is directly tied to a survey that could be sitting in your inbox? It is a complicated (and possibly antiquated) process but it is the one that will be used to determine our payments. To better explain how it all works I am sharing an FAQ from ACC Health Affairs Committee Chair, William Van Decker, MD, FACC, who has many years of experience in this space. If you have a survey - please thoughtfully fill it out. I am happy to answer any questions you may have about it.

David Winchester, MD, MS, FACC

President, Florida Chapter ACC

We’ve seen messages about the PPIS in The Advocate, social media, ACC.org, and different listservs. Why so much outreach on this unusual topic? 

Information about practices’ overhead costs is a key component of the payment formula that Medicare uses to set rates for physician services. This data was last updated using a similar national survey that began in 2006. Information from that survey promulgated changes in fee schedule payment amounts that had significant impacts on overall payment rates for different specialties. Some were steady and did not change much. Some went up significantly. And some went down significantly. It is important practices participate and do so thoroughly and accurately, so the best data is available to policymakers when these fee schedule formula inputs are updated. A page with additional information is on ACC.org.

 

Given the importance of the survey and its potential for significant future impacts, what should members do? 

Step one is for you and your colleagues and your staff to keep an eye out for emails from Mathematica, the survey contractor. Invitations about the costs survey will be sent by Mathematica from the email address PPISurvey@mathematica-mpr.com with the subject line: “American Medical Association requests your input on physician practice expense and patient care hours.” Invitations about physician hours worked will come from the email address PhysicianHoursSurvey@mathematica-mpr.com with the subject line: “Please help to update accurate physician payments.” Surveys will be in the field in waves through the spring of 2024. All cardiologists, regardless of ACC or AMA membership status are eligible to receive these surveys.

 

How hard will the survey be to do if one receives it?

The survey about practice costs will be rather involved. It will direct respondents to rely on 2022 tax information, 2022 payroll and benefit information, and other accounting information. It will be necessary to work on this with the CFO or finance department or practice manager, depending on your practice. The vendor will work with practices to try to find all the information if one person does not have access to everything requested. I won’t estimate how long it might take because it is not short and because it will vary greatly depending on the practice.

 

A separate survey about physician hours worked will also be sent out more broadly. This survey is shorter and will take 5-10 minutes to complete. While a shorter exercise, it is equally important to accurately consider the number of hours of direct patient care. The creation of a payment input for indirect practice expense per hour for each specialty can only be derived with accurate and valid responses.

 

If surveys started July 31, is it too late to pay attention to this issue?

Not at all. Because of the complexity of the practice costs survey, it is going to take some coordination to acquire all the necessary information and then ensure it is entered into the tool correctly. That is why the process for response collection is open through April 2024. The other reason is only the first wave of the survey—about 30% of the sample pool—has been distributed. The other 70% of surveys will be sent in a second wave in October. So keep working on these if you have one, keep aware that you may still receive one, and contact ACC, AMA, or Mathematica staff at any point along the way with questions.

@FloridaACC

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