How are doctors combating declining Medicare rates? By doing more procedures:

Ginsburg also said stagnant reimbursement rates for Medicare patients does not mean Medicare patients are less lucrative than they were four years ago. Doctors are billing Medicare for more services per patients, such as lab tests, cardiovascular stress tests and echocardiograms.

Expect this to continue as reimbursement declines.

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  • Anonymous

    NPR reported this morning how the recent cuts in Medicare reimbursement hasn’t resulted in reduced access for Medicare recipients. [I have to wonder sometimes at the quality of their reporting]. As if a sample one week into the year is going to represent in any way the consequences of a rate change that occurred a week before. Most practices are receiving payments for services rendered in the last months of 2005, not from the present year. The new rates are for services rendered after the first of the year. Those payments won’t be received for several weeks.

    The real test will be to look at access six months from now, when current year charges are the majority of a typical practice’s income stream. The picture might not be so rosy then. Once the effects of the cuts are seen in the bottom-line figures, in the practice monthly reports around mid-year, you may see more decisive measures from practices that will affect access as predicted. But I doubt that changes will be made before evidence is in hand.

  • Anonymous

    This is a report on ACCESS to physicians. REIMBURSEMENT is a different issue entirely. Medicare providers have only until the end of the year to opt-out of Medicare for the following year. Therefore, if they have not already done so, they’re stuck with Medicare for another year. Furthermore, the 2006 rates are going to be adjusted back to the 2005 rates, once the house/senate get their budget concerns worked out. So we’re not really likely to see any change at all.

  • Anonymous

    Two great postings. One other thing. I believe that the fee schedule will be resolved on or about February 1st up to 2007.

  • Kara

    My personal physician has a solution..he doesnt deal with Medicare or anyone on that program.

    In fact, he isnt even an insurance provider at all. He wont deal with them. You pay him directly. The benefit? He charges what he wants and I get an hour apt.

  • Anonymous

    “This is a report on ACCESS to physicians. REIMBURSEMENT is a different issue entirely. Medicare providers have only until the end of the year to opt-out of Medicare for the following year. Therefore, if they have not already done so, they’re stuck with Medicare for another year. Furthermore, the 2006 rates are going to be adjusted back to the 2005 rates, once the house/senate get their budget concerns worked out. So we’re not really likely to see any change at all.”

    Access is driven by reimbursement. Patients who want to be served but who have poorly reimbursing plans generally have fewer choices of providers. Viz Medicaid. No doctor is ever “stuck” with Medicare. You can drop it at any time, it isn’t like a prepaid HMO plan with a fixed contract period.

    As for what the Congress does on re-convening, that remains to be seen. The fact remains that the programmed cuts have gone into effect and will stay that way until new legislation (I think the bill is pending before conference committee, last I heard) reverses the cuts. The sooner they do so the better.

  • Anonymous

    Bad news for the doctors around here….

    we are fast approaching a day and age when Medicare will become a de facto monopoly on health care spending.

    When that happens, very few doctors will be able to drop medicare, even if reimbursement is cut.

    Medicare is rapidly approaching the status of the “only player in town.” Once the baby boomers start enrolling, doctors will be screwed

  • Anonymous

    To 10:22

    Two facts should be remembered in the future you predict:

    1. There will still be patients who need care,

    2. Physicians will still be needed to deliver that care.

    Medicare may or may not be part of the picture.
    Part B has only been around since 1967. Before then, people paid for their care themselves and
    filed with their insurers themselves for reimbursement. They could do so again.

    Just because Medicare ratchets down their reimbursements doesn’t mean that costs go down.
    Of course they don’t. And doctors won’t necessarily work for less, just because Medicare wants to pay less. If you are a Medicare-eligible patient who depends on getting a doctor who accepts Medicare rates and those rates just don’t cover the costs of services in your area, you may have a very tough time finding a doctor at all to see you.

    Medicare can only make its market so far. Below the local threshhold for fair return, there simply won’t be a market for Medicare-funded services, just as in some places there isn’t a market for Medicaid services. People won’t work for peanuts just because that is all you want to pay.

    Might some doctors relocate? Certainly. Especially the ones whose practices are in places where patients are dependent on Medicare payment and where there is generally not enough affluence to afford to pay bills in cash or to afford better-paying
    private insurance premiums.

    Who will get care depends on who pays and how the payments accommodate the costs and risks, just like any business. Doctors won’t practoice at all if they can’t cover costs and make an acceptable living. They won’t be working for teacher pay, if that is what you are thinking.

    Bad news for doctors? Maybe. Much more likely to be bad news for patients.

  • Anonymous

    “Medicare is rapidly approaching the status of the “only player in town.” Once the baby boomers start enrolling, doctors will be screwed’

    That is the seedbed for cash-only care, either via exclusive private methods, or where the government polices, via black market economics.

    This isn’t new. It’s command economics. That is what prevailed in East Bloc countries before the Wall fell. Miserable public clinics with underpaid staff and long waits. Secret private clinics for the party elite.
    Better black market service for those willing to pay cash. Hey, back to the future for you.

  • Anonymous

    You mean physicians will perform more tests to make more money? But I thought it was all attributable to defensive medicine! Oh what a tangled web we weave. . .