September 30, 2011

In anticipation of the next Medical Group Management Association (MGMA) survey this fall regarding Medicare reimbursement, it is worth noting results from MGMA’s most recent survey wherein the MGMA asked its physician members “which business considerations are currently under discussion by your practice due to this [Medicare] reimbursement uncertainty?”

The “yes” response rates to this question should be troubling to policymakers and, of course, to beneficiaries.  Of particular interest:  more than a quarter of respondents indicate they are considering “opting-out” of Medicare altogether.  (Of course, this pales in comparison to the 60% of doctors who looked into opting out on account of earlier reimbursement challenges according to a recent AMA survey.)[1]   

                                                                                                                           Yes

Limit the number of new Medicare patients                                             67.2%

Refuse to accept new Medicare patients                                                   49.5%

Cease treating all Medicare patients                                                          27.5%

Reduce the number of appointments for current Medicare patients    56.3%

These responses are consistent with further Physician Foundation survey findings wherein 60% of doctors said that “health reform” will compel them to close or significantly restrict practices to certain categories of patients.  Eighty-seven percent of the 60% (52% overall) said they would close or significantly restrict their practices to Medicare patients. Moreover, 93% of these doctors (56% overall) said they would close or significantly reduce their practices to Medicaid patients.  And Medicare physician reimbursement is scheduled to drop well below that of Medicaid in the President’s government takeover of healthcare law as detailed in the CMS Actuary’s graph below.[2]  This certainly does not bode well for future Medicare access under current Administration policy.   

“Most Florida physicians are considering completely ‘opting out’ of Medicare….This will result in Medicare patients experiencing major difficulties finding a physician to treat them and a tremendous increase in the wait to get an appointment with a physician. Seriously ill patients would be forced to seek care in emergency rooms.

 ***

 “I am concerned about what lies ahead. In the face of extreme payment cuts and a failing system, my colleagues in our state and across the nation may not be able to continue providing care for millions of Medicare patients.

 “President Barack Obama's promise that Americans can ‘keep their doctor’ is in serious jeopardy.”

 –Dr. James Dolan, President Florida Medical Association

 

Key Take-Aways  Medicare reimbursement uncertainty is prompting doctors to consider limiting access to new and even current Medicare patients. Many surveyed doctors are considering opting out of Medicare altogether. The President’s government takeover of healthcare law will only exacerbate the problem as Medicare reimbursement is scheduled to fall well below that of Medicaid.