PHYSICIANS:
Payment Fluctuations Don't Stop Physicians From Accepting Medicare Patients
Published on Fri Jan 27, 2006
Medicare acceptance relies on more than physician reimbursement, study suggests
Physician advocates' fears that inadequate reimbursements will force practices to turn away new Medicare patients may not hold water.
Physicians' willingness to accept new Medicare patients over the past few years shows insignificant effects from payment rate fluctuations, according to a study the Center for Studying Health System Change released Jan. 9. Nearly three-quarters of those physicians who participated in the survey reported that their practices were open to all new Medicare patients during 2004 and 2005--no significant change from acceptance levels during 2000 and 2001, the study reveals.
"Despite fluctuations in both Medicare physician payment and access during the past 10 years, Medicare beneficiaries' access to physicians remains high and is on par with physician access for privately insured patients, even though Medicare payment rates average about 20 percent less than private insurance rates," notes HSC senior researcher Peter J. Cunningham, Ph.D.
The study's results offer some consolation to providers and benes alike in lieu of the pending Deficit Reduction Act of 2005, which would invoke a physician payment freeze and reverse the 4.4-percent increase that went into effect Jan. 1, 2006.
Acceptance Levels Remain Flat Despite Payment Fluctuations
Medicare patient acceptance levels show no statistically significant change compared to levels seen in 2000 and 2001, the study concludes. Nearly 73 percent of physician practices accepted all new Medicare patients in 2004 and 2005, with only 3.4 percent accepting none, the study finds. Physicians accepting "some" Medicare patients totaled 9.7 percent, and those accepting "most" Medicare patients totaled 14 percent.
The study's results challenge physician advocates' assertions that payment reductions have a direct and dramatic impact on Medicare benes' access to providers. The study's statistics actually show an inverse relationship--when physician payment rates increased between 1997 and 2001, the percentage of physicians accepting all new Medicare patients declined from 74.6 to 71.1 percent. The study reflects the same trends in physician acceptance among patients with private insurance. Physician Capacity Constraints, Practice Incomes Offer Greater Insight
If payment rates alone don't open or close provider doors to Medicare patients, additional factors are clearly at hand. "While concerns about Medicare beneficiary access have focused on physician payment, policy makers should recognize that Medicare fees are only one factor in physician decisions to accept new patients," says HSC president Paul B. Ginsburg, Ph.D. "In other words, Medicare fees don't exist in a vacuum."
Instead of a direct payment-to-acceptance relationship, trends uncovered in the study may reflect a connection to loosened physician capacity constraints, suggests HSC. Increasing physician office visits in the 1990s, which caused many physicians to accept fewer new patients, have leveled off since 2001.
There may also be a connection between Medicare acceptance and physician practice incomes, the study suggests. [...]
