GOVERNMENTMedicare payment -- past, present, future: A "rational" system unraveledPhysicians face flagging practices, time-consuming patient care and temptations to throw in the towel when it comes to Medicare. Part 2 of a 3-part series.By David Glendinning, amednews staff. Oct. 2, 2006.
Chicago-area seniors who just turned 65 or who recently moved into town needn't bother contacting Ellen Brull, MD, to see if she will take them on as patients. Two years ago, the family physician made the difficult decision to stop accepting new Medicare patients. Several times a week, her practice receives calls from beneficiaries hoping to set up a first visit with the doctor only to find out that they must keep searching for a medical home. "I'm committed to the patients that I have, and I don't mind spending time with them even though I don't get reimbursed for all of it," said Dr. Brull, who practices in Niles, Ill. "I just couldn't make ends meet if I agreed to see all Medicare patients." At the heart of the problem is a Medicare physician payment formula that ties doctors' reimbursements to the nation's economy and cuts rates across the board when total physician spending exceeds annual limits. Because federal payment rates have stayed nearly flat in recent years while the costs of running a practice have steadily gone up, Dr. Brull's final take-home income this year will be no higher than it was in 2002, she said. When she decided to see only currently established Medicare patients, who make up about 30% of the practice, Dr. Brull hoped to bring in enough reimbursement from private-pay patients to make up for the financial loss that she was taking by continuing to treat seniors. But so far, this strategy has not been enough for the practice to do anything but tread water. [...]Full text of American Medical News content is available to AMA members and paid subscribers.
Copyright 2006 American Medical Association. All rights reserved.
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