More Physicians No Longer Seeing Medicare Patients

The federal health program that serves seniors and individuals with disabilities is losing doctors who’ll see its patients.

• The Centers for Medicare and Medicaid Services says the number of doctors who’ll take Medicare patients is falling.
• A combination of constant battles over reimbursement rates, red tape and payment below what services actually cost has simmered for a long time.
• Medicare now faces the same tell-tale signs of trouble as Medicaid, the low-income health program.  One-third of primary care doctors won’t take new patients on Medicaid.
• While the number of Medicare decliners remains relatively small, the trend is growing.  If it continues, that could make it more difficult for seniors to get timely treatment. 

More doctors are reducing their dependence on Medicare.  They’ve done this in several ways.  At the same time, the Medicare population is growing because of the retirement of baby boomers now and over the next couple of decades.

The number of doctors not accepting Medicare has more than doubled since 2009.  Some 9,539 doctors dropped out of Medicare practice in 2012.  That’s risen dramatically from 3,700 in 2009.

• Now, 81 percent of family doctors will take on seniors on Medicare, a survey by the American Academy of Family Physicians found.  That figure was 83 percent in 2010.
• Some 2.9 percent of family doctors have dropped out of Medicare altogether.  In 2010, 2.8 percent reported taking this dramatic step.
• More doctors are practicing on a “concierge” or cash basis.  Four percent of family practitioners now work on that model.  That’s higher than the 3 percent in 2010. 

While 685,000 doctors take Medicare patients, their frustration factor has grown.

• Perennial struggles to stop automatic cuts in Medicare provider payments have grown old.  The so-called “sustainable growth rate” always gets averted at the last minute, with its looming 25 percent cuts.
• In some locations around the country, seniors increasingly run into problems finding doctors who’ll take Medicare.  That could spell delays in needed treatment.
• Medicare pays for services at rates significantly below their costs.  Medicaid has long paid less than Medicare, making it even less attractive.  If doctors accept patients in these programs, there’s no negotiation over rates.  The government dictates prices on a take-it-or-leave-it basis.
• Some private-pay doctors find that eliminating the layers of paperwork allows them to charge reasonable rates for their services.  Many cite this model as promoting price transparency and more apt to curb healthcare costs.

Efforts to contain Medicare spending may show signs of being a double-edged sword.  You can’t arbitrarily cut provider payment rates without consequences.  It seems one consequence is driving more doctors away from Medicare at the time Medicare’s population is growing.  Health leaders advocate market-based, consumer-centered incentives that drive both higher quality and cost containment without subjecting providers and patients to harsh situations.