‘Significant’ Number of Doctors Refusing To Treat New Medicare Beneficiaries

"For the first time, significant numbers of doctors are refusing to take new Medicare patients" because of a 5.4% cut this year in reimbursement rates to physicians who participate in the program, the New York Times reports in a March 17 front-page story (Pear, New York Times, 3/17). The Medicare reimbursement rate for doctors is set by CMS annually according to a formula, approved by Congress in 1997, that is based in part on changes to the nation's gross domestic product (Kaiser Daily Health Policy Report, 1/15). While doctors have "expressed frustration" with Medicare in the past, the reaction to the current rate cuts "appears to be different," the Times reports. According to the American Academy of Family Physicians, 17% of family doctors no longer accept new Medicare patients. According to some doctors, the Medicare cuts are "magnified" because private insurers often model their reimbursement amounts after the government rates. The decrease in physicians accepting new Medicare patients is making it more difficult for the elderly to find doctors, the Times reports, "just as the need increases with the aging of the population." Dr. Robert Hogue, president-elect of the Texas Academy of Family Physicians, said, "I have a hard and fast rule. I don't take any new Medicare patients. In fact, I don't take any new patients over the age of 60 because they will be on Medicare in the next five years." The Bush administration, however, has said that any funding increase to physicians must be offset by cutting Medicare reimbursements to others. Meanwhile, the Times reports that hospitals, nursing homes and HMOs are also "demanding more money" for treating Medicare recipients, and HMOs have dropped 2.2 million Medicare beneficiaries in the last four years, saying that reimbursement is too low (New York Times, 3/17).