NCPA - National Center for Policy Analysis

Medicare is Bitter Pill for Doctors

January 23, 2004

The Association of the American Physicians and Surgeons, in its biannual survey of its members on the effects of Medicare on their practice, has concluded that practice changes will decrease availability of many services to Medicare beneficiaries.

The survey addresses five areas: access by established Medicare patients, acceptance of new Medicare patients, costs and changes to practices, opting out and private contracts, and assessment of the future of the practice. The survey responses -- which are not from a representative sample of all doctors -- suggests:

  • Increasing fear of prosecution or government retaliation has had a negative impact on Medicare patients' access to physicians; physicians are accepting new Medicare patients at a 16 percent lower rate since 1999, instead they prefer uninsured patients, turning them away 50 percent less frequently than Medicare patients.
  • Compliance with Medicare regulations is costly, takes significant times away from patient care, and is an increasing cause of reluctance to treat Medicare-eligible patients; respondents estimate it costs, on average, $22 to process a Medicare claim, compared to $14 for a private claim.
  • Sixty-five percent of respondents indicate that if they were starting their practice today, they would not take part in Medicare.

The findings indicate that some physicians are increasingly disheartened and negative about governmental involvement in Medicare. They suggest that lifting restrictions on private contracting under Medicare would greatly increase willingness to treat Medicare-eligible patients.

Source: Kathryn Serkes, "Disheartened Doctors, Patient Problems: AAPS Biannual Survey of Physicians on Medicare and Patients' Access to Care," Journal of American Physicians and Surgeons, Winter 2003.


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