Cutting Medicare, Cutting Care: Who Pays the Price
Medicare rules can feel distant until they change what happens in the exam room. Today we sit down with board-certified dermatologist and leading advocate Dr. Sandy Marchese Johnson to explain why a new CMS proposal has physicians calling it a “three-part bomb” and why patients should care right now.
We start with the uncomfortable math: Medicare physician reimbursement has effectively gone down over decades, even as inflation and practice expenses rise. Then we translate policy into real life. The proposed modifier 25 change could cut payment when we evaluate a problem and do a procedure on the same day, the exact kind of efficient, patient-friendly visit many people depend on. That can push clinics toward split appointments, more travel, more time off work, and delays for things like biopsies or treatment of multiple concerns in one visit.
We also dig into the overhead most patients never see: staffing ratios, supplies, rent, insurance, and the technology required to run a modern dermatology practice. Proposed changes to indirect expense calculations could hit in-office specialties especially hard and accelerate consolidation, shrinking access to independent private practices. Finally, we talk about who gets a voice in how medical services are valued, why clinician input matters, and what the CMS timeline looks like from public comment to potential January 1 implementation.
If you’ve ever wondered why call-backs take longer, why waitlists grow, or why clinics ask you to come back for something that used to happen the same day, this conversation connects the dots. Subscribe, share this with someone who relies on Medicare, and leave a review with your biggest question about how these rules should be written.
DISCLAIMER: The views and opinions expressed in the Derm-it Trotter! podcast are those of the host and guests and do not necessarily reflect the views or positions of the guests’ or host’s institution or employers. The Derm-it Trotter! Podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user’s own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such conditions.
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