Physicians Limiting New Medicare Patients Over Low Payment Concerns

More physicians are refusing new Medicare patients than ever before because of low reimbursements from the federal government, according to recent surveys from national and state medical societies, USA Today reports.

According to an American Academy of Family Physicians survey, 13% of respondents did not participate in Medicare in 2009, an increase from 8% in 2008 and 6% in 2004.

According to the American Osteopathic Association, 15% of its members do not participate in Medicare and 19% do not accept new Medicare patients.

In addition, an American Medical Association survey found that 17% of more than 9,000 physicians restrict the number of Medicare beneficiaries they serve. The rate is 31% among primary care physicians, according to the AMA survey.

Further, other reports have found that physicians in several states are exiting the program or limiting patients:

• 18% of physicians in Illinois restrict the number of Medicare beneficiaries they serve, according to a medical society survey;
• 117 North Carolina physicians have left Medicare since January, according to the state's medical society; and
• About 1,100 doctors in New York have opted out of Medicare.

Some physicians are limiting Medicare patients in part because Congress has been slow to stop a scheduled 21% cut to Medicare payments, which many already considered too low. Medicare paid physicians an average of 78% of what private insurers paid in 2008, USA Today reports.

CMS said that 97% of physicians still accept Medicare beneficiaries. Deputy Administrator of the program Jonathan Blum said the agency does not know how many doctors are refusing new Medicare patients, but "Medicare beneficiaries have good access to physician services."

The trend could become a larger concern going forward. In six months, the first wave of millions of Baby Boomers is expected to enroll in Medicare (Wolf, USA Today, 6/21).