Report: Doctors Refusing Medicare Patients

USA Today reports this morning that doctors are starting to refuse to accept new Medicare patients due to cuts in payments:

WASHINGTON — 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.

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.

It’s really just simple economic reality. Already, Medicare reimbursement rates are far below what most insurance companies pay for the same procedures, and even further below the actual cost to physicians of providing those services. In some cases, it’s not even worth it for doctors offices to spend the time filling out the paperwork Medicare requires to recieve the minimal amounts that it pays. At some point, it was inevitable that doctors would start to catch on to the scam and start closing their doors to new Medicare patients.

There are only a few ways that this can resolve itself.

  1. Doctors continue opting out of Medicare, meaning that as Baby Boomers retire they find it more and more difficult to find a primary care physician;
  2. Congress enacts the so-called “Doc Fix” which is supposed to increase reimbursements to physicians. The problem with this is that it would increase the cost of ObamaCare, and the Federal Budget Deficit, by hundreds of billions of dollars; or,
  3. Congress starts making it more difficult for doctors to opt out of Medicare.

None of these are ideal solutions, of course, but my guess is that we’re going to end up seeing a combination of 2 and 3, and that doctors are going to be told that they cannot refuse new Medicare patients if they want to receive reimbursement for existing Medicare patients.


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