Providers Remain Somewhat Satisfied

The 2008 Medicare Contractor Provider Satisfaction Survey (MCPSS) indicates that Medicare health care providers continue to be moderately satisfied with services provided by Medicare fee-for-service (FFS) contractors.

On a scale of 1 to 6 (6 being completely satisfied), providers say overall contractor performance measures up to a 4.51 satisfaction level, according to the MCPSS survey. In 2007, the average score for overall contractor performance was 4.56, according to a report released by the Centers for Medicare & Medicaid Services (CMS). Carriers and Part B Medicare Administrative Contractors (MACs) received an average score of 4.35—somewhat lower than their counterparts.

CMS asked providers to rate their contactor performance satisfaction levels for provider inquiries, provider outreach and education, claims processing, appeals, provider enrollment, medical review, and provider audit and reimbursement. Over 35,000 providers responded.

Meanwhile, some physicians are deciding to no longer accept health care insurance in part or in whole. In an effort to spend less time on paperwork and more time with patients, a minority of providers are opting for a running cash-based practice (Texas Medical Association, Aug. 26).

The two most commonly used cashed-based practices are:

  • Annual fee model – Also known as a retainer practice, patients pay an annual fee for special services not covered by managed care plans. A 2005 study by the Government Accountability Office (GAO) shows that about three-fourths of concierge practices still bill insurance and Medicare for covered services.
  • All-cash model – Patients pay fees up front or per service. The practice does not bill or contract with insurance companies at all. However, patients can file reimbursement claims to their commercial payers.

Running cash-based practices might appeal to the uninsured, which included 45.7 million people or 15.3 percent of the U.S. population in 2007, but with the median household income in 2007 at $50,233 (US Census Bureau, Aug. 26), that may not be feasible. What do you think is the likelihood that the running cash-based practices will become mainstream? Let us hear from you.

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