Lower Payments Do Not Decrease Access, GAO Finds
Reductions in Medicare payments to physicians have not resulted in a decrease in the number of providers accepting Medicare beneficiaries or made it difficult for beneficiaries to find providers, according to a Government Accountability Office report released on Friday, Reuters/Arizona Daily Star reports (Reuters/Arizona Daily Star, 7/22).
Since the early 1990s, some lawmakers, health policy analysts and physician groups such as the American Medical Association have raised concerns that reductions in Medicare physician payments will lead some providers to stop accepting beneficiaries as patients, CQ HealthBeat reports.
The GAO report, which was requested by Congress as part of the 2003 Medicare law, examines beneficiaries' perception of physician availability from 2000 to 2004; beneficiaries' use of physician services from 2000 to 2005; and physician supply and physician willingness to accept beneficiaries as patients from 2000 to 2005 (Carey, CQ HealthBeat, 7/21).
According to the report, which analyzes CMS data, concerns about decreased access to providers "were heightened in 2002" when Medicare physician payments were reduced 5.4% to lower spending increases.
However, the report finds that no more than about 7% of beneficiaries have experienced "a major access difficulty." In addition, the report states, "Only a small fraction -- less than 4% -- of physicians responded that they did not accept any new Medicare patients" (Washington Post, 7/22).
Overall, from April 2000 to April 2005, the percentage of beneficiaries who received physician services and the number of physician services that were provided both increased, the report finds. "These increases suggest that there was no reduction in the predominant tendency of physicians to accept Medicare patients and payments," according to the report.
In a response included in the report, AMA said the GAO analysis "should not be interpreted as an improvement in access," adding that the increased use of physician services could be the result of beneficiaries being sicker, more beneficiaries receiving physician services in doctors' offices rather than in hospitals or other settings, or beneficiaries' increased use of new Medicare benefits (CQ HealthBeat, 7/21).
The report is available online. Note: You must have Adobe Acrobat Reader to view the report.