Reimbursement:

So why is Monroe County losing physicians? In September 2005, the Monroe County Medical Society, as part of the Rochester Physician Workforce Task Force, interviewed physicians relocating to other communities. Of the several reasons doctors gave for leaving Rochester, the No. 1 reason was low reimbursement.

Little can be done to boost Medicare and Medicaid payments, since those reimbursement rates are set by the federal and state governments, respectively.

Commercial insurers throughout the country, in turn, set payment schedules based on a percentage of Medicare. In Rochester, the average commercial insurers reimburse doctors at about 125 percent of Medicare, and some specialties are even lower.