Fewer Doctors Accepting Medicare Patients Due To Payment Uncertainties

USA Today reports that “The number of doctors refusing new Medicare patients because of low government payment rates is setting a new high, just six months before millions of Baby Boomers begin enrolling in the government health care program.” There have always been doctors who do not accept Medicare due to lower payment rates compared to private insurance but the number is now increasing due to uncertainty about future payments due to the flawed physician payment formula:

Recent surveys by national and state medical societies have found more doctors limiting Medicare patients, partly because Congress has failed to stop an automatic 21% cut in payments that doctors already regard as too low. The cut went into effect Friday, even as the Senate approved a six-month reprieve. The House has approved a different bill.

• The American Academy of Family Physicians says 13% of respondents didn’t participate in Medicare last year, up from 8% in 2008 and 6% in 2004.

• The American Osteopathic Association says 15% of its members don’t participate in Medicare and 19% don’t accept new Medicare patients. If the cut is not reversed, it says, the numbers will double.

• The American Medical Association says 17% of more than 9,000 doctors surveyed restrict the number of Medicare patients in their practice. Among primary care physicians, the rate is 31%.

The federal health insurance program for seniors paid doctors on average 78% of what private insurers paid in 2008.

“Physicians are saying, ‘I can’t afford to keep losing money,’ ” says Lori Heim, president of the family doctors’ group.

In past years Congress has acted at the last minute to override steep cuts called for under the payment formula but this year there has been increased uncertainty as the Republicans have repeatedly played politics to prevent a long term fix. If the scheduled 21% cut is not reversed it is anticipated that far more doctors will stop accepting Medicare patients. This cut would place Medicare payment closer to the level of Medicaid, which already suffers from difficulties in access to care.

Medicare not only covers those over the age of 65. The program covers many who are disabled, and the Tricare program which covers U.S. military personnel and their families also pays based upon the Medicare fee schedule.

This year, after attempts at a permanent fix were blocked, the fee cuts have been blocked in temporary measures which have only been effective for one to two months. The Senate finally passed a six month fix last week but payments from June were already being sent out at the reduced rates. The fix would restore the cut fees retroactively but now Nancy Pelosi is threatening that the House will not pass this until the Senate also passes a jobs bill. While a jobs bill is also necessary, these are two separate issues and Medicare beneficiaries should not be forced to suffer while Congressional Democrats are fighting to pass a jobs bill.

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5 Comments

  1. 1
    SteveAR says:

    In past years Congress has acted at the last minute to override steep cuts called for under the payment formula but this year there has been increased uncertainty as the Republicans have repeatedly played politics to prevent a long term fix.

    Democrats created this problem, not Republicans.  The hypocritical Democrats convenieeeently left out the “doc fix” from the Obamacare health deform in order to get the CBO to ignore the “doc fix” when considering Obamacare’s cost and to get the support of the sell-out AMA.  Now that the health deform is in place, the Dem hypocrites want to put that cost back in.
    Saying Republicans are causing a problem here is completely dishonest and a perpetuation of Democratic agitprop.

  2. 2
    Ron Chusid says:

    No Steve, it is the Republicans who created this problem. It is the Republicans who played politics trying to include the “doc fix” into the cost of health care reform when this is an entirely different issue. If not for the Republicans doing this the fix could have been included in the health care reform legislation as originally intended. Republicans again have played politics on multiple occasions both when the Democrats tried to pass a permanent fix and each time they try to pass a temporary fix.

  3. 3
    SteveAR says:

    No Steve, it is the Republicans who created this problem. It is the Republicans who played politics trying to include the “doc fix” into the cost of health care reform when this is an entirely different issue. If not for the Republicans doing this the fix could have been included in the health care reform legislation as originally intended.

    Wrong.  Democrats played politics by keeping the “doc fix” out of Obamacare, deliberately to try to have the CBO score the legislation as something it isn’t, a cost-savings measure.  Democrats knew that the even the CBO’s preliminary scoring would not have been favorable to them if forced to include the “doc fix” in it, which is why it was left out.
     
    Democrats played politics, and now Democrats want Republicans to cover the Democrats’ political malfeasance.

  4. 4
    Ron Chusid says:

    Fewer Doctors Accepting Medicare Patients Due To Payment Uncertainties-will worsen if "doc fix" not passed. #p2 http://bit.ly/d6FgPb

  5. 5
    Ron Chusid says:

    That makes no sense. The doc fix never should have been part of the score for health care reform. It is a totally separate issue for a problem dating back to 1997. It is the Republicans who played politics and are spreading misinformation by claiming that this fix has anything to do with the cost of health care reform.

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