A 2011 MedPAC (Medicare Payment Advisory Commission) sponsored telephone survey of Medicare beneficiaries reported in MedPAC’s “Assessing Payment Adequacy: Fee Schedule and Ambulatory Surgical Center Services” (December 15, 2011) can be interpreted to suggest nearly two million beneficiaries may be having problems finding a new primary care physician or new specialist.
When MedPAC’s survey findings are extrapolated to the entire Medicare population of approximately 48 million the numbers of people having access issues are quite high despite their low percentage representation in the survey as noted in parentheses below. Among all Medicare beneficiaries, those experiencing a “small problem” in their search for a new primary care physician would number 336,000 (0.7%) while 624,000 (1.3%) would have a “big” problem (based on extrapolated survey responses). For access to new specialists, 528,000 (1.1%) would have a “small problem” while approximately 480,000 (1.0%) would have a “big” problem (again based on extrapolated survey responses). In total, nearly 2 million out of 48 million beneficiaries would be having access issues. Such numbers would leave no doubt that current Administration policies affecting Medicare patient access are failing the American people.
In the interest of extreme caution, what if the MedPAC survey findings are extrapolated to only 2% of the approximate 48 million Medicare population or just 1 million beneficiaries. Would the numbers of people affected justify concern? In this scenario, those experiencing a “small problem” in their search for a new primary care physician would number 7,000 (0.7%) while 13,000 (1.3%) would have a “big” problem (based on extrapolated survey responses). For access to new specialists, 11,000 (1.1%) would have a “small problem” while 10,000 (1.0%) would have a “big” problem (again based on extrapolated survey responses). In total, 41,000 Medicare beneficiaries would be having access issues. This is hardly an insignificant number.
MedPAC confirms its 2011 survey results are higher than in previous years and MedPAC Chair Glenn Hackbarth has called the trend “worrisome” possibly because only 5.6% and 14.7% of survey respondents respectively were even looking for a new primary care physician or new specialist.
Moreover, these numbers should be understood within the context of a recent survey of physicians regarding Medicare participation.
The Medical Group Management Association (MGMA) 2011 survey regarding Medicare reimbursement, asks doctors how they would respond to looming payment cuts relied upon in the President’s government takeover of healthcare law. The President could have but did not directly address this critical issue despite 2,700 pages of legislation.
The “yes” and “uncertain” response rates to this question should be troubling to policymakers and, of course, to Medicare beneficiaries. Of particular concern, more than half of respondents suggest they would consider “opting-out” of Medicare altogether:
Reduce the number of appointments for new Medicare patients
Reduce the number of appointments for current Medicare patients
Stop accepting new Medicare patients
Only accept established patients aging into Medicare
Cease treating all Medicare patients