CMS Needs to Improve Data Gathering on Medicare Beneficiaries’ Access to Doctors, GAO Official Says
CMS should make "significant improvements" in its data collection to determine whether recent cuts in payments to Medicare providers will affect beneficiaries' access to care, William Scanlon, director of health care issues for the General Accounting Office, wrote in response to queries by members of the House Energy and Commerce Subcommittee on Health (Yochelson, BNA News Medicare Report, 3/20). Medicare payments to doctors this year were cut by an average of 5.4% and could decrease even further next year under the existing reimbursement formula, which ties compensation to changes in the gross domestic product (Kaiser Daily Health Policy Report, 1/22). The New York Times on March 17 reported that "significant" numbers of providers were declining to care for new Medicare beneficiaries because of the cut in payments (Kaiser Daily Health Policy Report, 3/18). In February, the House Energy and Commerce Subcommittee on Health held a hearing on the issue and asked witnesses to respond to follow-up questions in writing. In particular, subcommittee Chair Michael Bilirakis (R-Fla.) and ranking member Rep. Sherrod Brown (D-Ohio) asked Scanlon how CMS could determine Medicare beneficiaries' access to doctors, considering that the agency's most recent data on the topic is from 1999. In his response, Scanlon wrote that CMS should make "available more quickly" claims data collected for payment purposes to help identify access issues "in specific locations or among certain specialties." State claims data also could help detect problems that might be "masked by national aggregation," he said. In addition, claims data could be combined with information from beneficiary surveys to create a more complete picture of provider access, Scanlon said. He wrote that he could not answer subcommittee members' questions about access problems specifically for Medicare beneficiaries living in rural areas (BNA Medicare Report, 3/22).
Diane Rehm Show
NPR's "The Diane Rehm Show" on March 20 featured a discussion about Medicare reimbursement rates with Dr. Paul Ginsburg, president of the Center for the Study of Health System Change; AARP Policy and Strategy Director John Rother; and Dr. Baretta Casey, a private practice physician. Rother said that AARP's most recent surveys estimate that approximately 4% of Medicare patients "have trouble" obtaining care. Noting that physicians have "always limited their practice," he said, "Most patients may not be able to get the first doctor they go to, but ultimately they usually find a doctor." Ginsburg said that an HSC physician survey in 2001 found that approximately 3% of physicians were not accepting new Medicare patients. Rother said, "Members of Congress are hearing from all sides in health care. ... [I]t is a very difficult job on their part to try to balance this out with only a limited number of dollars, so you really do have to make some priority decisions to try to keep the whole system working." The full segment is available online in RealPlayer Audio (Page, "The Diane Rehm Show," NPR, 3/20). See related story in the Opinion section.
