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MedPAC hears that pay cut hurts access

Looming second year of Medicare pay reductions could deepen the problem.

By Markian Hawryluk, amednews staff. Oct. 7, 2002.

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Washington -- A new survey shared with an influential congressional advisory panel shows that this year's 5.4% Medicare physician pay cut has had some impact on patients' access to doctors. But it remains unclear whether lawmakers will act in time to prevent another cut next year that could worsen the situation.

The physician survey conducted by Project Hope on behalf of the Medicare Payment Advisory Commission indicated that 96% of doctors are still accepting at least some new Medicare patients, virtually unchanged from 1997. But it found that the number accepting all new Medicare patients had dropped from 76% in 1999 to 69% in 2002.

"Acceptance of patients is being affected by the physicians' concerns about reimbursement," said Julie Schoenman, PhD, senior research director at Project Hope. "The higher the level of concern about reimbursement, the more likely the physician is to say that he or she was limiting the number of new patients accepted."

The survey mirrors the findings of other research, but it is the first statistically valid look at national physician acceptance rates after the Medicare cuts went into effect.

Researchers also found that 11% of physicians had changed priorities in appointment schedules this year, with two-thirds downgrading the priority for Medicare patients. The survey also found that doctors were having trouble referring fee-for-service Medicare patients, much more so than private indemnity patients but not as much as Medicaid and HMO patients.

AMA Trustee William G. Plested, MD, called for Congress and the Centers for Medicare & Medicaid Services to address the payment shortfall. [...]