Despite widespread claims that doctors are fleeing Medicare, more than 9 in 10 still accept new Medicare patients and fewer than 1 percent have quit the program. The vast majority of seniors have regular access to a doctor and can find a physician when they need one. And Medicare patients are no more likely than others to have to wait for a timely appointment. Nearly all say they always or usually can see their doctor when they want to.
According to a new report by the Kaiser Family Foundation, 96 percent of seniors say they have access to care in a doctor’s office or clinic.
The report is important because Congress is once again grappling with how much Medicare should pay physicians. More than 15 years ago, lawmakers scheduled a series of pay cuts for Medicare docs but each year since has postponed the reductions. If all those delayed cuts took place now, physician pay would be slashed by nearly 25 percent. But for the first time in years, Congress may be closing in on a long-term solution to the mess.
Some physician advocates have argued that docs are abandoning Medicare patients in the face of relatively low payment rates and uncertainty over future compensation. If that’s true, it would be tough for Congress to hold down future pay increases. But the Kaiser report, based on 11 different government and non-governmental studies, concludes there is simply no evidence that physicians are bailing out.
While doctors overwhelmingly continue to take Medicare patients, it is true that some are more enthusiastic than others. For instance, primary care and family practice doctors are somewhat less likely to accept new Medicare patients than many specialists.
Overall, 87 percent of family medicine physicians are taking new Medicare patients, a bit lower than the 91 percent average among all docs. But among specialists, 99 percent of general surgeons and 98 percent of orthopedic surgeons take new Medicare patients compared to only about 63 percent of psychiatrists.
There are geographical differences too. In states such as Maine, Maryland, Rhode Island, and Oregon, only about 80 percent of docs are taking new Medicare patients. On the other hand, in Florida, Wyoming, Delaware, and South Carolina more than 95 percent of docs are doing so.
This variation isn’t much of a surprise since there are also big differences in what doctors get paid by private insurance compared to what they get from Medicare, both by geography and specialty. For instance, in 2010 the Center for the Study of Health System Change found that standard insurance rates were lower than Medicare in Miami and LA but much higher in parts of Wisconsin.
The Kaiser Foundation, which is separate from the Kaiser Permanente HMO, also looked at whether access was different for patients in traditional fee-for-service Medicare compared to those in Medicare Advantage managed care plans. Kaiser reported almost no difference. In a 2012 Medicare survey, 88.2 percent of those in traditional Medicare said they “always” or “usually” got an appointment for routine care as soon as they needed it while 87 percent of those in MA plans said the same.
Similarly, 91.8 percent of fee-for-service patients said it was always or usually easy to get an appointment with a specialist compared to 91 percent of MA participants.
While no doubt many doctors are frustrated and angry about current Medicare payments and complex regulations, only a handful are quitting the program. Most are continuing to see their Medicare patients and even are accepting new ones.
That story that many Medicare patients can no longer find a doctor turns out to be little more than another Internet myth.
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