AMA warns Medicare payment cuts would harm patient care and access

An Association survey shows that many doctors would be unable to invest in quality-improving technology and would be forced to cut back on patient services.

By David Glendinning, AMNews staff. April 25, 2005.

Washington -- If Congress fails to reverse the impending Medicare payment cut to physicians before the end of the year, J. Edward Hill, MD, worries that the suffering won't be limited just to patients seeking new doctors.

A recent American Medical Association member survey shows that his fears are warranted. Not only would many doctors stop accepting new Medicare patients, but they would be forced to put off investments in their practices that could improve patient care, the poll found.

Dr. Hill, the AMA president-elect and a family physician from Tupelo, Miss., reported that many physicians in his part of the country already are starting to think twice about launching or maintaining disease-management services for existing patients. This relatively new type of program has shown promise in coordinating care for seniors with chronic diseases, often with the help of health coaches who assist patients in managing their conditions between office visits.

"To run a really good disease-management program, you probably need electronics, but you probably also need health professionals to help monitor these patients, and that's expensive," Dr. Hill said. "The concern is that physicians won't be able to run their congestive heart failure disease-management program or their diabetes disease-management program because they can't afford the salaries of more personnel."

This concern is underscored in the AMA member survey, which found that more than half of physicians plan to defer purchases of medical equipment or information technology if they sustain a Medicare cut next year. A comparable number of doctors said they would decrease staffing levels if the 2006 reduction, now estimated at 4.3%, goes through. The number of doctors planning these steps would increase significantly if current law were to remain unchanged and cause multiple years of cuts.