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MACRA Is The Death Knell Of Podiatry

MACRA is a sounding bell for the death of podiatry and possibly medicine as we know it. The results of MACRA will ultimately be revealed to all of medicine by 2019 and then in 2024. Although the outcry heard from AMPA poses a considerable opposition, it is a drop in the bucket compared to the big picture. In order to delay this payment model, partnering with large medical organizations such as AOA and AMA will have to be within podiatrists game plan. Either way, this payment model is coming with full force. Ultimately, the purpose of this payment model is so CMS can eliminate the independent physician.

The majority of podiatry is employed by other podiatrists or in private practice. Because podiatry is deemed not to be a money maker hospitals and larger medical healthcare corporations are opting for cheaper options. The evidence is against podiatry and the proof is in podiatrys inability to show the cost effectiveness in what it does.

This is especially pertinent when CMS and OIG are both attacking podiatrists based on perceived fraud, abuse and exploitation when it comes to standard foot care. Not to mention the procedures that pay generously to podiatrists; however, are not actually even needed. With the advent of CMS of the medicare reveal on payments by this federal program and last year’s release to the public by the Wall Street Journal along with the Comparative Billing Reports for CPT codes 11720/11721 and E/M podiatry have a tough battle to show it is a worthwhile specialty.

Podiatry has too much of a concentration of independent doctors dependent upon medicare as the foundation of their financial support. Furthermore once MACRA becomes fully operational in 2019 podiatry is going to have problems if it does not change soon. This will be the the last straw on whether podiatry can thrive in the future.

If podiatry does not prove ourselves as needed parts of the healthcare picture, what podiatry has to provide will be replaced by the likes of PAs and NPs. At that point podiatry will become an afterthought within medicine. The only thing that may save this profession is the DPM/MD. If we podiatry cannot come together and accomplish and support this profession, podiatrists should consider moving to another profession.

February 5, 2017

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