Poll: If payment cut takes hold, 1 in 4 DOs to stop seeing Medicare patients

If the 21.3% cut in Medicare physician payment takes effect on June 1, nearly a quarter of osteopathic physicians say they would probably or definitely drop their Medicare patients, according to an independent poll commissioned by the AOA.

Barely two out of five DOs said they are likely to keep seeing their Medicare patients if the cut is implemented, the poll found. One-third of respondents were undecided.

In contrast, 94% of DOs would probably or definitely keep seeing Medicare patients if Congress restructures payment rates to accurately reflect the cost of care.

Based on interviews with DOs who have a say in deciding what type of insurance to accept at their practices, the poll results clearly reflect physicians’ dissatisfaction with Medicare’s reimbursement methodology, according to AOA President Larry A. Wickless, DO.

“These numbers should be a wake-up call to policymakers,” Dr. Wickless said in a statement issued on May 12, the day the AOA announced the poll results.

The cost of providing health care has grown by more than 20% during the past 10 years, while physician payment has remained nearly static, according to the AOA. In a letter to every member of Congress, Dr. Wickless noted that physicians are paid only approximately 1% more than they were in 2001.

“The good news is that if Congress were to create a Medicare payment formula that provides annual increases based upon annual increases in practice costs, an overwhelming majority of physicians will continue to participate in the Medicare program,” Dr. Wickless wrote.

Unsustainable SGR

The AOA and other medical associations have long advocated reforming the Medicare physician payment formula to ensure annual increases in physician payment based on rising practice costs.

The poll respondents indicated these are their top concerns with the sustainable growth rate (SGR) formula used to calculate Medicare physician payment:

1. Medicare payment rates do not increase at the same rate that medical costs increase.
2. The current payment formula does not adequately cover the cost of care provided.
3. Congress’ temporary fixes are unreliable, with reimbursement rates potentially fluctuating monthly.

Although their sample size is small, approximately one-third of the respondents who do not accept Medicare patients indicated that they would start accepting them should the payment formula be reformed.

During the the AOA’s May 12 telephone news conference to announce the results, AOA Executive John B. Crosby, JD, reiterated the AOA’s support for the health care reform law but noted that the association is “very concerned” that Congress has failed to act on reforming the SGR formula. “Reform of physician payment is health care reform and is sound economic policy,” Crosby stressed.

”Physicians are having a harder time operating their business,” Shawn Martin, the AOA’s director of government relations, said during conference call. “And for them to provide access to Medicare, Medicaid or any patients, for that matter, they have to be able to operate a business.”

The next day, during the AOA and the Michigan Osteopathic Association’s online town hall meeting, Crosby said the AOA is working diligently to get Congress to extend the freeze on the Medicare cut “and to come up up with a long-term, permanent solution.”

Poll particulars

From April 28 to May 1, Benenson Strategy Group interviewed 1,021 AOA members who spend at least 20% of their time in direct patient care.

The poll’s margin of error is 3% but is higher among subgroups, such as the subset of DOs who at least share in the decision on what type of insurance to accept at their practices. Nearly half of the respondents, or 48%, qualified for this category.

Of the DOs participating in the survey, 55% describe themselves as primary care physicians, 26% as specialists, and 19% as general surgeons or surgical specialists. Two-thirds of the respondents practice in an ambulatory or private practice.