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.)
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. 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
 Other survey responses to earlier reimbursement challenges: 14% “cancelled or postponed scheduled services to Medicare patients” and 13% “temporarily closed practice to new appointments with Medicare patients.” In response to a hypothetical significant reimbursement reduction, 54% of respondents said they would “restrict the number of Medicare patients they treat”; 50% would “stop taking new Medicare patients”; and 31% would “stop taking any Medicare patients.”
 CMS, Projected Medicare Expenditures under an Illustrative Scenario with Alternative Payment Updates to Medicare Providers, May 2011, http://www.cms.gov/ReportsTrustFunds/Downloads/2011TRAlternativeScenario.pdf