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Survey Says Doctors Will Trim Staff If Medicare Payments Are Cut

By Mary Agnes Carey, CQ HealthBeat Associate Editor

September 7, 2007 -- Reductions in Medicare physician payment rates would not only restrict beneficiaries' access to physician services but will also cause staffing reductions in doctors' offices, according to a new survey from the Medical Group Management Association (MGMA).

Unless Congress acts, Medicare payments to physicians will be cut by about 10 percent January 1. The House version of legislation (HR 3162) to reauthorize the State Children's Health Insurance Program (SCHIP) would reverse that cut and increase physician payments over the next two years. The Senate SCHIP measure (S 1893) does not address the physician payment issue.

In the MGMA survey, more than 41 percent of respondents said they may have to limit the number of Medicare patients they see if Medicare reimbursements are reduced and more than 19 percent said they would not accept new Medicare patients. In addition, 57 percent of physicians who responded to the survey they would have to reduce staff health care benefits coverage to remain financially viable and 44 percent would cut administrative staffing levels. A third of respondents said they would cut clinical staffing levels and 9 percent would cut the number of physicians in their practice.

Of additional concern to MGMA members, the poll also indicated that nearly 63 percent of respondents said private insurance companies with which they had contracts made changes to their 2006 payment rates based on the Medicare fee schedule, which froze Medicare reimbursements. Of those practices, 51 percent experienced up to a 5 percent reduction; 22 percent experienced up to a 10 percent reduction, and nearly 9 percent experienced up to a 25 percent cut.

"Beyond the impact on practices with higher Medicare-beneficiary patient populations is the domino effect these payment cuts will have when private payers follow suit and reduce their payments across the board," said William Jessee, MGMA president and chief executive officer. "Even practices that have already restricted their Medicare patient volume will feel the pinch."

MGMA conducted its Medicare access questionnaire in July, six months after Medicare reimbursements to physicians were frozen and six months before the impending decrease would take effect. MGMA collected responses from more than 631 members, representing 13,686 practicing physicians.

A survey released earlier this year by the American Medical Association (AMA) found that 60 percent of the group's members said they would limit the number of Medicare patients they see if the proposed 2008 Medicare cuts become law.

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