Medicare Payment Flaws Can Affect Patient Care and Access

July 23rd, 2008 at 09:19am Brian Knabe

  Brian J. Knabe, MD

The Medicare physician payment formula continues to confound doctors as they try to run their practices as well as plan for the future.  As I described in my last entry, there is a formula in place which is scheduled to cut payment for physician services by 40% over the next decade, while the costs to run a practice are projected to rise by 20%.  In the short-term, the formula will hand physicians a 10.6% cut in Medicare payments this month unless Congress and the President take action.  This issue may have a significant impact on baby-boomers, as the number of Medicare enrollees is expected to rise to 44 million by 2011 and to 50 million by 2016.

The most obvious way that these cuts may affect patients is through decreased access to physicians.  The Medicare Payment Advisory Commission found that 30 percent of Medicare patients searching for a new primary care physician had trouble finding one.  Moreover, an AMA survey of nearly 9,000 doctors found that 60 percent would have to place limits on the number of new Medicare patients they could accept if the scheduled cuts should occur in 2008. 

The flawed payment formula can also affect the quality of medical care in less obvious ways.  An AMA survey last year found that 54 percent of physicians would have to reduce staff and 67 percent would delay the purchase of information technology if the 2008 cuts were to be enacted.  A short-term fix is certainly needed this month, but a long-term solution is really required in order to enable physicians to make long-term investments to help their practices and to benefit patients.

I am happy to say that the legislators representing the Rockford area – Congressman Manzullo and Senators Durbin and Obama – have voted in favor of a temporary fix for the problem.  You can help the situation by thanking your representatives, and by encouraging them to find a solution for the longer term.

Entry Filed under: Medicine