Doctors not taking Medicare patients. True of False?

Have you heard that more and more doctors are dropping out of Medicare because they don’t get paid enough?  Is this fact or fiction?  It turns out that studies have been done to provide an answer to this question.

The Medicare Payment Advisory Commission (MedPAC) is an independent congressional agency established by the Balanced Budget Act of 1997  to advise the U.S. Congress on issues affecting the Medicare program.  The March 2011 MedPAC report addressed the question of Medicare beneficiaires’ access to doctors, especially primary care doctors.

MedPAC found that over 90% of doctors who accept Medicare are taking new patients. Another independent study found that 92.9% of doctors accept Medicare patients. This was reported in a New York Times article in July.

Here are the findings of the March 2011 MedPAC report:

Overall, beneficiary access to physician services is good or better than that reported by privately insured patients age 50 to 64. For example, in 2010, 75 percent of beneficiaries reported that they had no problem scheduling timely routine-care physician appointments.

Multiple surveys show that most physicians are accepting Medicare patients. For example, the 2008 National Ambulatory Medical Care Survey found that 90 percent of physicians with at least 10 percent of their practice revenue coming from Medicare accepted at least some new Medicare patients.

Medicare’s payment for physician fee-schedule services in 2009 averaged 80 percent of private insurer payments for preferred provider organizations, a figure unchanged from the preceding year.

A recent study found that in 2007, hourly compensation rates for some specialties were more than double the rate for primary care. The Commission has recommended enhancements to primary care, such as increasing Medicare payments for primary care services provided by primary care practitioners. (Note:  The 2010 Affordable Care Act increased payments to primary care doctors by 10%.)

In 2009, the Medicare margin for the median efficient hospital was 3.0 percent. (We define efficient hospitals as those that consistently perform relatively well on cost, mortality, and readmission measures.) While most of these relatively efficient hospitals generate profits on Medicare patients, about one-third do not.

What Next?

Related Articles

One Response to "Doctors not taking Medicare patients. True of False?"

  1. debrabodkin says:

    After I pay monthly insurance premiums I can’t afford the co-payment to go. Honestly, they got you where they want you, only solution is “Penny Health” trying to find a solution for this

Leave a Reply

Submit Comment