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Not Enough Data To Explain Why Doctors Are Leaving Medicare

Source: http://www.businessinsider.com/medicare-2012-1

The government is having a hard time conducting a full review of physicians who have opted out of medicare, according to a memo released last week by the Department of Health and Human Services. 

The evaluation sought to answer what type of physicians opted out, whether the number of physicians opting out increased or decreased over time, and why the physicians chose to opt out. 

According to deputy inspector general Stuart Wright, the evaluation was not completed because Centers for Medicare and Medicaid Services (CMS), Medicare Administrative Contractors (MACs) and legacy carriers do not maintain sufficient data. 

While CMS provided the Office of Inspector General (OIG) with 7,900 providers ranging from 1998 to March 2011, only one out of 10 MACs and one of six legacy carriers provided OIG with all data elements required by CMS. Consequently, the OIG claimed it could not sample opted out physicians and interview them. 

The memo implied that the number of physicians opting out will increase in the future, considering “the potential for legislated decreases in Medicare reimbursement for physician services. ” It briefly references a 2011 August report published by the Texas Medical Association, which reported that 50 percent of Texas physicians are considering dropping out of Medicare program altogether. 

This trend is nothing new. TMA has released another report in March 2011 that showed that 34 percent of Texas doctors are not accepting new Medicare patients or have limited the number of doctors. Similarly, a report by AARP released in February 2010 surveyed 413 Idaho physicians and found that 17 percent have completely closed their practices to new Medicare patients.

The Physicians’ Foundation has published numerous reports on the topic. A 2008 survey reported that 12 percent of physicians have closed their practices to Medicare patients and the 2010 survey reported that 52.2 percent of physicians said that health reform would cause them to “close or significantly restrict their practices to Medicare patients.”

Now See: Why doctors are loosing money >

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