Many Physicians Refuse to Take New Medicare Patients, Cite 5.4% Reduction in Reimbursement Rates
"For the first time," significant numbers of doctors are refusing to take new Medicare patients because of a recently enacted 5.4% cut in reimbursement rates to physicians who participate in the program, the New York Times reported in a front-page story Sunday (Pear, New York Times, 3/17). The Medicare reimbursement rate for doctors is set by CMS annually according to a formula approved by Congress in 1997, which is based in part on changes to the nation's gross domestic product (California Healthline, 1/15). While doctors have "expressed frustration" with Medicare in the past, the reaction to the current rate cut, which took effect Jan. 1, "appears to be different," the Times reports. According to the American Academy of Family Physicians, 17% of family doctors no longer accept new Medicare patients. Some doctors say the Medicare cuts are "magnified" because private insurers often model their reimbursement amounts after the government rates. The decrease in physicians accepting new Medicare patients is making it more difficult for the elderly to find doctors "just as the need increases with the aging of the population," the Times reports. Dr. Robert Hogue, president-elect of the Texas Academy of Family Physicians, said, "I have a hard and fast rule. I don't take any new Medicare patients. In fact, I don't take any new patients over the age of 60 because they will be on Medicare in the next five years." The Bush administration, however, has said that any funding increase to physicians must be offset by cutting Medicare reimbursements to others. Meanwhile, the Times reports that hospitals, nursing homes and HMOs are also "demanding more money" for treating Medicare beneficiaries, and HMOs have dropped 2.2 million Medicare beneficiaries in the last four years, saying that reimbursement is too low (New York Times, 3/17).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.