Medicare Update

It is a common misconception that doctors make tons and tons of money. While they are highly paid, we have to remember what goes into becoming a doctor.

• Most doctors start their practice with over 100K in debt and loans.
• They have worked for years to become full-fledged doctors and spend their days (and nights. and weekends- trust me I know) caring for the ones we love.
• Doctors employ a lot of people to keep their practices running.
• They have to pay huge amounts for their malpractice insurance.

The article below is about the changes in Medicare payments to doctors. I have this conversation about 3 times a week with my husband and he and his practice are among the doctors considering not accepting Medicare because they would actually lose money treating those patients. This is not something they want to do. They want to be able to treat patients and get on with their day.

I want to emphasize one point this article makes: As the federal government continues to give its employees raises and bail out Wall Street bankers for billions of dollars, Congress intends to cut payments to America's lifeline - the doctors - by twenty-one percent.

Think about that.

The article:

Docs4PatientCare would like to inform you that Medicare payments to physicians are scheduled to be reduced by twenty-one percent (21%) this Monday, March 1st. D4PC is asking doctors to carefully weigh their options. The decision deadline to remain a participating doctor in Medicare for the calendar year 2010 is March 17, 2010. This decision is retroactive for payments back to January 1, 2010.

Medicare is a government program for health care benefits for the elderly and disabled. When originally introduced, Medicare closely paralleled commercial health insurance. Over the years Medicare payments have not kept up with inflation, such that payments now are only one percent (1%) higher than 2001. In the same time frame, overhead expenses for Medical practices have risen twenty to thirty percent. Now, with the reduction of payments by one-fifth on Monday, doctors are faced with tough choices. Many physicians see the impending cuts as a major challenge to the viability of their practice.

Doctors have the choice to participate in Medicare and accept the Medicare fee schedule as payment in full (80% from Medicare, 20% from the patient or secondary insurance.) This is called participating or "PAR".

Doctors may also choose not to participate, "Non-PAR", but they will be restricted on fees they can charge to slightly more than Medicare. In this case, Medicare will pay on a reduced-fee schedule, approximately 76 percent of charges, and patients will still pay a copayment, which may reach 24 percent of charges.

Doctors may also opt to "privately contract" with patients, in which case Medicare will not pay any of the bill. Instead, the patient will be totally responsible for the bill.

As the federal government continues to give its employees raises and bail out Wall Street bankers for billions of dollars, Congress intends to cut payments to America's lifeline - the doctors - by twenty-one percent. D4PC expresses its concern that this drastic cut in payments may very well limit senior and disabled citizens' choices in seeking care.

If you would like more information on the upcoming Medicare changes from a D4PC member, please contact Amber Christian at (703) 548-1160.