Latest Push to Fix SGR Highlights Endless Tug-of-War in Medicare Reimbursement for Physicians
The largest casualties in the back and forth tug-of-war between Congress and the sustainable growth rate (SGR) are the patients, according to a recent survey conducted by the American Medical Association.
Out of 9,000 physicians surveyed in May by the AMA, 17 percent stated that they are treating fewer Medicare patients, with the two top reasons: that payments are too low, 83 percent; and that future cuts make Medicare an unreliable payer, 78 percent, an AMA press release stated.
The majority of physicians polled, 60 percent, stated that they reacted to the two short-term delays in a 21.3 percent Medicare payment cut by looking into how to opt out of Medicare and treat patients through a "private contracting option."
Fiscal consequences from the back and forth debate on the SGR included:
- Delayed payments for supplies, rent and/or other expenses (39%).
- Took out a loan or line of credit to continue paying bills (17%).
- Held up paychecks or laid off/furloughed staff (17%).
- Cancelled or postponed scheduled services to Medicare patients (14%).
- Temporarily closed a practice to new appointments with Medicare patients (13%).
No matter what the U.S. Congress does or does not do at this point with Medicare, the physicians in the study said that the SGR will affect how and if they treat patients with federal health insurance. If Congress enacts a four to seven month Medicare payment freeze with a final 21% payment cut, which was one of the latest proposals, 54 percent of those polled said they would restrict the number of Medicare patients they treat; 50 percent said they would stop taking new Medicare patients; and 31 percent said they would not take any Medicare patients.
In addition, if Congress enacts an increase in Medicare payments for three to five years with a 21 percent cut to follow, 48 percent of the physicians said that they would restrict the number of Medicare patients they treat; 42 percent would stop taking new Medicare patients; and 26 percent said they would not accept any Medicare patients. The survey can be found http://www.ama- assn.org/ama1/pub/upload/mm/399/medicare-survey-results.pdf.
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