Act now to maintain access to your doctor if Medicare payment rates go down
Article by David Lynch - Sun, 11/14/2010
For some time now, people covered by Medicare have been having an increasingly difficult time finding primary care physicians who will accept them into their practice. This has been a problem due to the fact that low Medicare rates of payment make it very difficult for primary care doctors to be financially successful. Now, there is a danger that this access problem might become a full fledged crisis around the nation.
On December 1, 2010 Medicare rates for physicians are scheduled to decrease by more than 23%, and then, on January 1, 2011, rates are scheduled to go down another 7%. This is not because of health care reform, but rather is due to Medicare's sustainable growth rate (SGR) formula, which automatically pays doctors less if the use of medical services paid for goes up, in order to "balance the budget". Congress has avoided fixing this problem, and now, with a likely Republican majority in one or both houses of the new Congress pledging no new spending, it is very possible that nothing will be done to rectify the situation.
On December 1, 2010 Medicare rates for physicians are scheduled to decrease by more than 23%, and then, on January 1, 2011, rates are scheduled to go down another 7%. This is not because of health care reform, but rather is due to Medicare's sustainable growth rate (SGR) formula, which automatically pays doctors less if the use of medical services paid for goes up, in order to "balance the budget". Congress has avoided fixing this problem, and now, with a likely Republican majority in one or both houses of the new Congress pledging no new spending, it is very possible that nothing will be done to rectify the situation.
Is there anything that you or a loved one on Medicare can do to maintain future primary care access if this happens? Fortunately, yes there is! Look into signing up with a Medicare Advantage plan that your doctor accepts which contracts directly with physicians to provide care for Medicare patients. These plans often work in creative ways with physicians to enhance primary care coverage, and save money by screening and treating early to reduce costs. Monday, November 15th is the official first day of the 45-day open enrollment period for Medicare beneficiaries to select Medicare insurance plans that best fit their needs. The enrollment period ends Dec. 31, 2010.
In my medical group, Family Care Network, we contract with four MA plans, and we ask all new patients to sign up with one of those in order to become a patient with us. Open enrollment for choosing a new Medicare Advantage plan begins November 15, 2010. A good approach is to ask your doctor's office what plans they work with, and then visit an independent Medicare insurance agency to review your options and pick the plan that is right for you!
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