The PCP who accept Medicare (and they are a diminishing number) continue in Limbo.
Medicare legislation contains a formula for calculating the reimbursement schedule. This arcane exercise is called the Sustainable Growth Rate or SGR for short. It is recalculated each year, and each year seems to call for a reduced reimbursement rate. It has been universally found inaccurate and each year congress votes to continue the existing rates through legislation…or at least for the last seven consecutive years.
We have blogged about this in the past, but the problem continues. Congress adjourned without resolving the issue and PCP are not being paid. They have been asked to continue to submit their bills at the “regular” rate in hopes Congress will take their usual action and a secondary corrective payment will not need to be made. But…no action to date.
We see continued evidence that PCP are simply “fed up”. They are already earning far less than other specialists, working longer hours, and they are more dependent on the government.
Many are seeking a “better way”. A Direct Care Practice solves most or all of the PCP objections. This “specialty” will continue to grow as Medicare recipients find it more difficult to find a PCP.