Low reimbursement threat: Senate must act now to keep Medicare healthy

It is up to the Senate to decide if physicians will be paid enough to ensure Medicare access for all seniors.

Editorial. Sept. 9, 2002.

Nov. 1 could be a day of reckoning for Medicare. That is the day the government unveils the final physician payment rates for 2003. Whether physicians decide on that day to leave the program in droves depends mostly on Congress.

The AMA has been relentlessly warning lawmakers about the potential consequences of inaction on the Medicare physician payment crisis. Now a new member survey drives home the point. It shows that if the government follows up this year's 5.4% Medicare physician payment cut with a hefty reduction next year, today's patient access problem could escalate into tomorrow's access emergency. Two out of five physicians, or 42%, would no longer sign the participation agreements that prevent them from billing patients more than the Medicare allowance.

Already nearly a quarter of doctors have decreased or restricted the number or type of Medicare patients they treat, or plan to do so.

The AMA hasn't been alone in sounding the warning. Surveys by the American Academy of Family Physicians, Medicare Rights Center and Center for Studying Health System Change confirm that many physicians no longer accept new Medicare patients.

If physicians are making these hard choices now, it's not difficult to imagine what would happen if the payment cuts predicted for coming years actually occur. If current estimates hold, physicians would see their payments from the program slashed nearly 23% between this year and 2005 (if compounding is factored in). [...]