November 18, 2011

The recently-released 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.[1]

The “yes” and “uncertain” response rates to this question should be troubling to policymakers and, of course, to beneficiaries.  Of particular interest:  more than half of respondents suggest they are considering “opting-out” of Medicare altogether.    

	Yes	Uncertain
Reduce the number of appointments for new Medicare patients	51.0%	33.1%
Reduce the number of appointments for current Medicare patients	34.8%	35.0%
Stop accepting new Medicare patients	30.9%	45.0%
Only accept established patients aging into Medicare	26.9%	47.4%
Cease treating all Medicare patients	9.0%	44.4%

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.[2]  And Medicare physician reimbursement is scheduled to drop well below that of Medicaid as detailed in the CMS Actuary’s graph below.[3]  This certainly does not bode well for future Medicare access under the current Administration.    

Dr. Mark McClellan, former CMS Administrator and FDA Commissioner, and now Director of the Engelberg Center for Health Care Reform at Brookings, explains the impact of current Administration policy and a positive direction for Medicare reform.

"Medicare's physician payment system illustrates the problems of trying to control costs just by squeezing down prices.  Physicians can't easily plan ahead because the future of their payments is unclear, and many are wondering about how long they will be able to keep serving seniors.  Health care providers, private plans, and states are trying to implement alternatives to improve quality and reduce health care costs.  Further Medicare reforms are needed to reinforce their efforts."

 

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.