If We Want Doctors to Return to Medicare, It Is Time to End The "Doc Fix"
Physicians Are Leaving Medicare in Part Because of the Uncertainty Created by the Regular Threat of Drastic Cuts to Medicare Physician Fees
Congress Always Suspends The Cuts and Will Do so Again This January – It's Time to End This Fraud Permanently
Washington, D.C. - "Every one to two years, Medicare threatens to drastically cut what it pays physicians. This is a big factor in helping to drive doctors away from Medicare," says Dr. David Hogberg, senior fellow at the National Center for Public Policy Research.
In an op-ed for the Washington Examiner entitled "To bring doctors back to Medicare, fix the 'Doc Fix'," Dr. Hogberg argues that it is time to end the physician cuts.
"The cuts are the result of a formula known as the Sustainable Growth Rate. When Medicare physicians fees exceed an expenditure target, the SGR is supposed to result in automatic, across-the-board cuts," he explains. "But it's a fraud. Congress is unwilling to make the cuts, so it routinely suspends the cuts and replaces them with a one to two percent increase in fees, a process known as the 'Doc Fix.'
"Congress will be doing it again come January, when a 25 percent cut in Medicare physician fees is scheduled to take place," he continued. "Congress will undoubtedly suspend it. But the problem is that this creates uncertainty among physicians. As a result, more and more physicians are limiting their exposure to Medicare."
A 2010 American Medical Association survey found that over three-quarters of the physicians who limit the Medicare patients they see cited the "ongoing threat of future payment cut makes Medicare an unreliable payer" as a reason.1
The op-ed points to the example of Dr. John Slatosky, a primary care physician in rural North Carolina. In 2007 he stopped seeing new Medicare patients because he worried the government might suddenly and dramatically cut the amount it paid him to treat Medicare patients. It was a decision that bothered him greatly, as now there would be Medicare patients in his area who would have to look for a doctor elsewhere.
"But, in the end, it was better to have a physician here seeing some of the Medicare patients in the area than me losing my business and having no physician here at all," said Dr. Slatosky.
In 2001, about 10 percent of physicians were no longer seeing new Medicare patients. Now it's 17 percent.2
By 2030, the number of Medicare patients will increase 50 percent above present levels. We need more physicians taking Medicare patients, not fewer, notes Dr. Hogberg.
"It's a sad state of affairs when doctors are forced to risk the financial health of their practices just to take on new Medicare patients," said Dr. Hogberg. "Congress needs to stop the Doc Fix kabuki dance and enact a permanent repeal of the SGR."
The National Center for Public Policy Research, founded in 1982, is a non-partisan, free-market, independent conservative think-tank. Ninety-four percent of its support comes from individuals, three percent from foundations, and three percent from corporations. It receives over 350,000 individual contributions a year from over 96,000 active recent contributors.
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1 "The Impact of Medicare Physician Payment on Seniors' Access to Care," American Medical Association, AMA Online Survey of Physicians, May 2010.
2 Donald K. Cherry, Catharine W. Burt, and David A. Woodwell, "National Ambulatory Medical Care Survey: 2001 Summary," Centers For Disease Control, Advanced Data From Vital and Health Statistics, No. 337, August 11, 2003; and Sandra L. Decker, "In 2011 Nearly One-Third Of Physicians Said They Would Not Accept new Medicaid Patients, But Rising Fees May Help," Health Affairs, August 2012, Vol.31, No. 8.