Effective Today: Medicare Cuts 2%


Medicare Reimbursements www.npbusiness.org

Nurse Practitioners and other clinicians are likely aware that effective today, Medicare has reduced your reimbursement by 2%.  While it does not sound like a lot, consider the compound effect of 2% over the year. This was the topic of discussion last week during the NPBO Members Only monthly Success Webinar. It’s critical that all practices take a close look at their financials and consider the possible ripple effect that this decline in reimbursements may have on other payers.

You’ll want to perform an assessment of your practice:

  1. What is the payer mix of your practice? Break out your patients by payer type. What percentage of your patients are Medicare, Medicare/Medicaid, and your other payers. You should carry this out for all payers.
  2. Note reimbursements for each payer. Pay attention as well to any secondary plans and if they actually pay. For example, Medicaid does not often pick up the 20% that Medicare does not pay.
  3. Calculate the effect this drop in reimbursement will have on your practice. What happens if other payers drop reimbursement? (Heads up…some of them are!)

While I have read that the Medicare cuts are coming solely from the 80% that Medicare pays you, I will not be surprised to find confusion with patients and other payers regarding deductibles and co-insurance.

It’s likely, at least for now, that these cuts will not be reversed. You’ll want to make sure your practice is diligent in collecting deductibles, co-insurance and co-pays as appropriate (and per your contracts), keep an eye on your payer mix, and watch your bottom line.


is a professional speaker, author, clinician and business owner who provides business education, resources and support to Nurse Practitioners, Physician Assistants and other Advance Practice Clinicians –  both for the employed and self-employed clinician.  Additional information about Ms. Phillips is available at www.BarbaraCPhillips.com.

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