This week, in response to the proposed 21% cut to Medicare reimbursement rates set to take effect on March 1, James Rohack, president of the American Medical Association (AMA), informed the organizations 250,000 members about their options – which include completely opting out of a Medicare contract.
Although CNN noted that Congress has at the last minute blocked those cuts from happening in seven of the last 8 years, Rohack and the AMA are no longer supporting any further "temporary fixes." In fact, the AMA wants the current law to be repealed and a new formula used "that more accurately reflects the cost of providing care" in determining Medicare reimbursement rates.
A permanent doc fix, which would correct this problem, is not part of any of the health care reform packages before congress including those previously endorsed by the AMA.
In preparing for the proposed cut, the AMA's Web site is providing information to doctors about how they can help their patients find other doctors if they decide to no longer accept Medicare. Additionally, members have asked the AMA to produce pamphlets with the same information that could be handed out to their patients.
One example that highlights the problem of Medicare reimbursement rates is Dr. Edward Kornel, a neurosurgeon based in White Plains, N.Y., who stopped seeing Medicare patients two years ago, along with his two colleagues who stopped in the past six months. While Dr. Kornel, who's been in practice for 27 years, said he had always accepted Medicare patients in the past, he was losing money.
He told CNN that when he looked at his income from reimbursements, he was losing money every time he took care of a Medicare patient." He further added that the reimbursement rates were not covering his costs. Specifically, “while Medicare patients accounted for about 20% of his total patient load, they were generating less than 5% of his income.” Dr. Kornel said that he would have to do “300 operations in one year just to break even." In addition, the American Association of Neurological Surgeons (AANS), to which Kormel belongs, has “warned that Medicare patients would likely get less access to doctors if Medicare payment cuts continue.”
Despite Dr. Kornel’s experience, the “Center for Medicare and Medicaid Services (CMS) said that its own data, and other industry reports, show only a small percentage of beneficiaries unable to get physician access.” Such data are disputed however by the fact that a survey of AANS’s 3,400 members showed 65% was referring their Medicare patients to other doctors. In fact, about 60% said they were reducing the number of Medicare patients in their practice, something AANS President Dr. Troy Tippet noted painted a “bleak path.”
Also echoing similar concerns was Dr. Priscilla Arnold, an ophthalmologist based in Bettendorf, Iowa, and past president of the American Society of Cataract and Refractive Surgery. Dr. Arnold told CNN that each year she is forced to “realistically evaluate” if she can continue to see all her patients. She also noted that the numbers from CMS did not account for doctors who are reducing the number of Medicare patients. As a result, if the cut is not changed, “many doctors in her specialty won't be able to sustain their practices.”
The concerns of these doctors should be echoed to your representatives and government officials before it’s too late. As Dr. Kornel asserted, "If doctors drop Medicare patients, people will be forced to go to clinics where it's hard to get appointments, the waits are long and you get far less attention than you would otherwise get." In order to avoid this potential “disaster” Congress needs to listen to patients and doctors before they have nowhere to go.