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I recently read two articles, "Shortages in Health Care Add Challenges" and "CMS Proposes 2007 Decrease in Medicare Reimbursement," in the Oct. 17, 2006 issue. As a private practice SLP, both articles deeply concern me for the same reason. With overall needed positions rising in health care to 40% and the Centers for Medicare and Medicaid Services' proposal to cut services by 5%, I feel that not only will this discourage existing SLPs to remain in the field but it will also discourage students who may be considering the field of speech-language pathology.
Typically during high supply and demand times, positions receive high levels of pay, bonuses, etc. Although these types of actions are being done according to reports, there appears to be a conflict. If CMS continues to decrease overall reimbursements, I can't see how companies can continue to recruit SLPs without placing unrealistic and unethical demands on the SLP hired. In addition, I certainly am not encouraged to remain in the field with constant reductions of pay, regardless of my abilities.
Certainly there are other answers to shortages, such as using assistants. However many states, such as my own, have never embraced the use of speech assistants to subsidize shortages. Obviously, other answers rely on CMS not to reduce reimbursement rates but to increase rates. I fear without major changes to the existing system, that we may be facing greater shortages in all areas of speech-language pathology. In fact, we may have to reassess what is important to us as professionals.
Tami Covey
Tulsa, OK
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