Becker's connected with M. Shafeeq Ahmed, MD, president of Johns Hopkins Howard County Medical Center in Columbia, Md., to discuss the risks the increasing number of physicians electing not to accept payments from Medicare poses to care delivery as a whole.
Note: This response has been edited lightly for length and clarity.
Question: Thirty-five percent of physicians surveyed by Medscape have said they are not sure if they will continue to accept Medicare. If those physicians were to drop Medicare patients, how will this affect patient care? How will this shift healthcare delivery as a whole?
Dr. M. Shafeeq Ahmed: I do understand that there are issues on both sides of this, but this trend does concern me. There is a real need to find a permanent "fix" for this issue, as it is detrimental to have this continual mismatch between the actual cost of care increases and Medicare reimbursements. With this in mind, the immediate effect on our Medicare patient population who will not be able to receive outpatient care would also be problematic. Specifically, there are already long-standing trends of lower primary care availability in many communities.
If this pressure were added to the other existing factors that cause a low supply of primary care, I would be concerned that the health outcomes for this vulnerable population would also be negatively affected. Cutting out specialty care options for Medicare patients would only further exacerbate this issue.
From a population health standpoint, having sicker patients present to costlier inpatient settings without adequate outpatient care or follow-up is not the best care delivery model, and will likely drive up the total cost of care in the long-run. I am hopeful that more can be done to proactively address the gaps and help avoid such consequences.