Each year, an obscure formula created by Congress many years ago calculates the amount of reimbursement doctor’s received for treating Medicare patients. The Congress has long understood this formula is outdated, inaccurate and simply wrong. Instead of correcting this anomaly, when the reimbursement reduction is calculated each year, they simply pass legislation negating the implementation of the reduction, thus allowing the existing reimbursement rates to stand.
This year was different in several ways. First, the reduction was huge…21%. That means physicians were to have their Medicare reimbursement rate reduced by 21%…that’s equivalent to each of us being told our pay is being cut by 21%…not a pleasant thought. The second significant change is Congress did not pass legislation negating this reduction and let it stand. Thus the seven consecutive years of legislation to mitigate this error was not passed this year. Why not we ask? Simple, the reduction amounts to an estimated $71 Billion and Congress needed that money in the “score card” the Congressional Budget Office (CBO) uses to determine the cost of the new health care legislation. Pass the legislation negating it, and the CBO estimate for the next decade would have been cut in half…and threaten the passage of health care legislation.
In the “What does this mean to me category….” it’s pretty simple. If the 21% reduction stands, it is estimated at least 20% of all doctor’s accepting Medicare will cease to accept Medicare. Add this to an already alarming number who do not want Medicare patients and we have a potential crises in Primary Care for Medicare patients.
Primary Care Physicians (PCP) are quickly disappearing at a time we need them most. How are we going to get access to health care? Does it matter we have insurance, Medicare or other means if we can’t find a physician willing to treat us?
One solution is Concierge Medical Practices, also known as Direct Care Practices. This emerging breed of practitioners provide immediate access on a round the clock basis, along with a variety of other important services.