Tim, I'm not sure what you mean when you ask nominal vs real vs what reimbursement where (sp) planned to have been, but as a medicare provider, I read our trade publications to mean that real YOY reimbursement will be cut 10%.
I have seen colleagues drop like flies over the last 5 years as they have not been able to keep up with the cost of doing business with medicare while their office costs, office space costs, instrument/technology costs and insurance costs all continue to rise. In addition to this, medicare has made it more and more difficult to follow-up on billing errors (often that they make) and the level of staffing of real people on the phone is getting worse. Trying to get their errors corrected is getting near to impossible.
regards
aj