Medicare reform helps doctors and patients

The physician payment increase will help prevent access problems for patients, but a permanent repair of the reimbursement formula is essential.

Editorial. Jan. 12, 2004.

Physicians will have a much happier new year thanks to the Medicare reform legislation signed into law last month. Instead of a 4.5% Medicare payment cut, doctors will get at least a 1.5% increase this year and next.

Not only that, but many physicians in rural and underserved areas will be eligible for 5% Medicare bonus payments. Lawmakers also took a step toward making payments in rural areas more equitable by eliminating for three years cuts that result from geographic adjustments to a portion of the payment formula.

The action by Congress and President Bush, supported by the American Medical Association, strengthens Medicare for physicians and the patients they serve. The new law prevents what would have been a "Medicare meltdown."

Had the cuts gone into effect, access for elderly and disabled patients to physician care surely would have suffered. Many doctors, faced with grim economic realities, would have been forced to trim services to seniors, to stop accepting new Medicare patients or to drop out of the program altogether. Physicians also would have faced a payment hit from private insurers, many of which base reimbursement on Medicare rates.

By reversing the scheduled cuts, Congress has preserved beneficiaries' access to physicians.

Millions of seniors and the doctors who care for them also will benefit greatly from the new law's outpatient prescription drug provisions.

While seniors wait for the new drug benefit to begin in 2006, they will get assistance this year in the form of drug discount cards, which lawmakers hope will knock up to 25% off drug prices. The much-needed help with drug costs will mean that more beneficiaries have the ability to buy the drugs their physicians prescribe.