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Planned Medicare cuts mean planned cuts in the practice
Physicians surveyed by the AAO and the AMA say they are being affected by the Medicare cuts, which in turn affect patients’ access to care.
WASHINGTON – Twenty-four percent of physicians will limit the number of Medicare patients they treat in the next 6 months as a result of Medicare cuts, according to a survey conducted by the American Academy of Ophthalmology and the American Medical Association.
The survey also showed that 42% of physicians said they would not sign participation agreements if the proposed Medicare cuts are approved for 2003.
These physicians also plan to make cuts in their practice in the coming year: 43% plan to postpone buying equipment, 26% plan to stop providing certain services, 22% plan to refer complex cases, and 21% plan to lay off staff. In all, 60% of the physicians said they would implement these changes. Of those, 51% are actively making these changes because of the 5.4% Medicare cut from January of this year.
The survey
The AAO and AMA surveyed physicians in an attempt to show how significantly medicine will be affected by the proposed Medicare cuts. The two organizations sent nearly 2,000 surveys between February and April of this year; 520 were returned.
“The purpose of the survey was to show how the cuts were affecting physicians across the country. They’re definitely feeling the pressure. These are things they will implement in the next 4 to 6 months,” said Catherine Cohen, AAO’s vice president for governmental affairs.
The results of the survey come late in the congressional year, with Congress putting off resolving tough Medicare payment issues until after the election. Though the House responded to physician groups’ pleas for Medicare reform, the Senate did not pass legislation. If they fail to act, a scheduled 4.4% cut for 2003 will go into effect in January.
“Ophthalmologists are hit hard due to their large caseload of Medicare patients, since they deal with many diseases that come with age,” Ms. Cohen said.
Physician groups such as the AAO have been trying to pass reform legislation on Medicare reimbursement. In July, the House passed the Medicare Modernization and Prescription Drug Act, which proposes a solution to the reimbursement issue they said is based on a faulty formula.
The lame-duck session in mid-November gave Congress a chance to try and finish its 2002 agenda. The AAO had the fix slated for that session but it is not assured a chance on the floor, Ms. Cohen said.
Patient groups speak out
In addition to the physician survey, Project Hope, a health care think tank, released their survey results showing that Medicare patients were being affected. Their poll showed 31% of physicians who accept Medicare patients are now limiting the number of new fee-for-service patients they treat.
The Medicare Rights Center, a patient advocacy group, conducted a survey that showed patients are having difficulty finding physicians who accept new Medicare patients. The group surveyed directors of state Medicare counseling programs and advocacy organizations in 30 states, Puerto Rico and the District of Columbia.
Patients from eight states (Tennessee, Missouri, Arizona, Virginia, New Hampshire, Texas, Rhode Island and New Mexico) reported having increased difficulty finding a physician since the beginning of the year. Medicare counseling or advocacy groups from Tennessee, Mew Mexico and New Hampshire said patients had been told by their physicians that Medicare cuts were the reason for not accepting new patients.
Although the survey links the Medicare reimbursement cuts as the source of patient access problems, they also reported that the decline existed prior to the cuts from 2002. Previously, 15 states had reported patients having access problems.
Though physicians may be declining new Medicare patients, the Medicare Rights Center said few physicians had cut their Medicare coverage.
Possible solutions
The AAO remains hopeful for relief regarding physician fee cuts. In addition to the pressure it has put on the House and Senate, they have funded two legal opinions showing that the Centers for Medicare and Medicaid Services (CMS) has the legal authority to make changes to the reimbursement fee schedule. Previously, the CMS had said they had no legal authority.
In addition, the CMS has said that proposed solutions to the alleged faulty payment schedule would be lengthy and costly. According to AAO documents, fixing the payment formula would cost $56 billion. The AAO said CMS could reduce costs by $16 billion if they remove the costs of drugs from the formula.
For Your Information:
- Catherine Cohen, AAO Vice President for Governmental Affairs, can be reached at 1101 Vermont Ave. NW, Washington, DC 20005-3570; (202) 737-6662; fax: (202) 737-7061; e-mail: cCohen@aaodc.org; Web site: http://www.aao.org.
- The Medicare Rights Center can be reached at 1460 Broadway, 11th Fl., New York, NY 10036; (212) 869-3850; fax: (212) 869-3532; Web site: www.medicarerights.org.