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GOVERNMENT & MEDICINERural doctors plead for equal payLawmakers from underserved areas also push for an easing of the geographic disparity in Medicare physician payment.By Markian Hawryluk, AMNews staff. Aug. 12, 2002. Washington -- Baretta Casey, MD, did exactly what Medicare hoped she would do. The family physician set out her shingle in her Appalachian home town of Pikeville, Ky., seven years ago. But every year Dr. Casey saw her practice's costs rise 10% to 15%, while payment rates failed to keep pace. In 2001, her expenses finally overtook her revenue. "I'm basically subsidizing my own practice out of a savings account," she said. Thousands of family physicians in rural areas are facing similar crises, and many believe Medicare payment policy is to blame. A 5.4% cut in Medicare rates in 2002 has only exacerbated previous funding shortfalls that are driving primary care doctors from rural areas. "If our reimbursement rates continue to go down and our expenses continue to go up, you will see an exodus of physicians out of rural areas like Moses out of Egypt," Dr. Casey said. "The practice of medicine is like any other business. If you can't pay your bills, you can't survive." Dr. Casey is now considering a move into academic medicine, rather than staying in solo practice. Although physician groups have maintained that the across-the-board cut in Medicare payments is still their top priority, many doctors and their representatives in Congress are now pushing for a reconsideration of the method used to adjust payment levels in different areas of the country. At a recent hearing of the House Ways and Means health subcommittee, more than a dozen lawmakers representing rural districts urged the panel to address the disparity in payments between physicians and hospitals in rural areas and their urban and suburban counterparts. [...] Full text of AMNews content is available to AMA members and paid subscribers.
Copyright 2002 American Medical Association. All rights reserved.
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