The Real-World Impact of Congressional Number Crunching

In June, MGMA sent its members a Medicare participation questionnaire. Of the 1,611 member practices representing more than 34,000 physicians who responded, 39 percent said they would limit the number of Medicare patients seen and 19 percent would refuse to accept new Medicare patients if the proposed 5.1 percent cut for 2007 moves forward. Participants were also asked what steps they might take to help mitigate the reduction in Medicare payments. The majority said they would postpone investment in new technology (80 percent), modify or eliminate staff healthcare benefits (67 percent) and/or cut administrative or support staff positions (54 percent). Other options included cutting clinical staff (39 percent) and cutting staff salaries (25 percent). A separate survey conducted by the American Medical Association found 45 percent of their respondents would decrease or stop taking new Medicare patients beginning in January. Over the nine-year life of the proposed cuts, nearly three-quarters of the surveyed physicians indicated they would defer the purchase of new medical equipment and almost two-thirds said they would wait to purchase new information technology. For patients, the cuts are expected to translate into limited access … and ultimately decreased quality. In Arkansas, a 14-physician cardiology practice said it would have to reduce its mobile services in rural areas. If that happens, some elderly patients would have to drive an hour-and-a-half to two hours for care. Administrators at the same practice said they might also have to reduce staff and benefits and worried that employees laid off might have a hard time finding new positions in the area's tight job market. In North Carolina, a 20-physician ENT practice is considering limiting the number of Medicare patients seen by the practice. Since the group is the only one in the area with ophthalmologists on staff, new Medicare patients would be forced to seek care through the hospital, which currently has a two-to-three month wait for appointments. "We try to avoid making decisions with a detrimental impact on patients," said the practice administrator on his MGMA questionnaire, "but we're not sure how much longer we're going to be able to shield them." December 2006