Ripple Effect Might Hit Non-Medicare Patients

The poll numbers were not good. About 67% of physicians in America said they’ll likely see fewer Medicare patients, and well over half of American physicians said they intend to cut administrative or clinical staff, if the roughly 30% cut in Medicare reimbursement goes through at the end of this year.

That’s according to a national report this week from the Medical Group Management Association.

“I think you’d find similar answers in California,” Andrew LaMar of the California Medical Association said. “Physicians will be in tough financial straits if they have to take a 30% cut in Medicare. And it will have a huge effect on access to care in California.”

At the annual CMA House of Delegates meeting earlier this month, it was the talk of the conference, according to CMA president James Hinsdale.

“California is not terribly different from other states,” Hinsdale said. “Society seldom puts money in the buckets for the things it mandates. And physicians are getting squeezed.”

When doctors get less money in Medicare reimbursement, there are several major ripple effects from that, LaMar said. Doctors feel it, but so will patients — Medicare and non-Medicare alike, he said.

“For patients, what could happen is, a senior citizen might not be able to find someone in their county to see them, or they might have to wait for months to get an appointment. Or the worst, they might have to go to the emergency room. Which is not the best way to get care, and it’s expensive, and the costs go to the taxpayers.”

About 50,000 physicians in California see Medicare patients, LaMar said. That number will decline if Medicare reimbursement is cut by almost a third, he said.

“The direct effect is, physicians can’t pay for their practice costs, so they can only see so many Medicare patients,” LaMar said.

“But a lot of contracts with insurers are based on what they make from Medicare. Some contracts say you get 110% of what you get from Medicare, or 120% of what you get from Medicare.”

So the lower federal reimbursements also affect insurer reimbursements, LaMar said — and that may lead to an even bigger reduction in clinical and administrative staff, from receptionists to medical assistants to nurse practitioners.

“And all of that reduces the number of patients a physician can see,” he said, “independent of any program.”

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