The Disappearing Medicare Doctors

One of the benefits of turning 65 used to be the ability to get medical care under Medicare. Free or low-cost medical care, just when you need it the most. Then came the fiscal cliff and the Affordable Care Act. Growing older with Medicare isn’t the safety net that it used to be. The cost of Medicare coverage is going up. Benefits are being cut. And now, faced with a 27 percent cut in payments, an article in Forbes, “27% Pay Cut Or Not, More Docs To Leave Medicare in 2013,” reports physicians are likely to bail out of the Medicare program altogether.

And who could blame them? If you were faced with a 27-percent pay cut at your job, wouldn’t you start looking? With salaries lower now than ever, who could survive a pay cut that drastic? Costs are rising for doctors at all levels, with the high cost of high-tech equipment and insurance rates. Retailers aren’t the only ones suffering from poor sales. Faced with higher deductibles and uncovered procedures due to a changing health insurance industry, people are delaying routine checkups and opting out of high-cost or optional tests or procedures. 

The American Medical Association wagged its finger at Congress for putting these physicians and their Medicare patients at risk. Unpredictable funding and cuts put 47 million Medicare patients and their physicians at risk. These elderly patients are often those who need medical care to deal with conditions that come with aging. More doctor visits and prescriptions are needed to deal with illness, chronic conditions and manage pain.

Lower reimbursement is a reality. The government has already lowered the fee schedule from a rate of $34.0376 to $25.0008. Unlike manufacturers or other service providers, doctors can’t lower the quality or quantity of services to match price cuts. McDonald’s can shrink the size of a burger, put fewer fries in the paper container or use smaller soft drink cups to cut costs. Doctors have to maintain or increase the level of service. To hold back could be a matter of life and death. No one gets hurt from McDonald’s cutbacks. But doctors have to deliver quality service despite price cuts or lower reimbursement rates.

Instead of lowering services, physicians are just pulling out. According to a 2010 AMA survey, about 9,000 primary care physicians are limiting the number of Medicare patients in their practices. As aging Baby Boomers reach 65, there will be fewer physicians willing to take new patients under Medicare. Some patients may have to switch doctors to find one willing to deal with Medicare cuts at a time in their life when they need the comfort of a familiar relationship with their physician. 

Medicare patients aren’t the only group suffering under the Medicare cuts. Insurance companies like United Health Care and Humana need physicians to participate in networks for their Advantage Plans, which contract with Medicare to provide services. 

Doctors, seniors, insurance companies and the government need to get on board to focus on the most important goal of Medicare—providing quality health care for an aging population that paid into a system promising affordable health care at a time when many need it most. There have been a number of fixes passed to prevent major cuts in medical reimbursement. It will take a concerted effort from all parties to find a solution that will give seniors what they worked for and paid into to make Medicare work for years to come

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