Why some physicians are breaking up with Medicare

Sixty-five percent of physicians plan to continue treating Medicare and Medicaid patients, according to Medscape's "Physician Compensation Report 2023," a 6 percent decrease from last year's report.

Though the majority of physicians are still planning to serve Medicare patients, those numbers may continue to fall if current policy trends continue. 

Several physicians and organizations have criticized recent policies regarding Medicare reimbursement and pay cuts. These policies include Congress' 2022 vote to cut Medicare payments by 2 percent and CMS' 4.48 percent physician fee cut.

Such policies could be a deterrent to treat Medicare patients, especially when, according to the Medscape survey, 22 percent of physicians have not yet decided whether they will keep or drop Medicare and Medicaid patients.

Medicare pays physicians around 80 percent of the reasonable charge for covered services while private insurers pay nearly double Medicare rates for hospital services, according to a June 1 Medscape article. Physicians that accept Medicare also face a host of billing issues, with 7.3 percent of physicians losing Medicare claims to billing problems, compared to private insurers losing an estimated 4.8 percent, according to Medscape.

"At a time when inflation is still of great concern, increased salaries, wages and benefits, and Medicare reducing provider compensation, you start to wonder when a payment reform will happen," Andrew Lovewell, CEO of Columbia (Mo.) Orthopedic Group told Becker's. "The cost curve and reimbursement curves are not being adequately addressed by both payers and the federal government. Running a practice today costs substantially more than it did five years ago, but the reimbursement for services hasn't been increased to offset or equalize the increased costs."

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