Nov. 30--A majority of Connecticut doctors who took part in an online survey said they would stop seeing Medicare patients or reduce those patients' access to care if Medicare rates are reduced Wednesday, as scheduled.
But it appears the 23 percent cut to Medicare reimbursement rates will be postponed at least a month. The U.S. House approved a bill passed earlier this month by the Senate to push back the rate cuts.
In advance of those cuts, the Connecticut State Medical Society's online survey drew responses from 360 doctors in Connecticut from various fields of medicine. Of those, 78 percent said they would limit Medicare patients' access to care if the pay cuts went into effect Dec. 1.
At issue is the ballooning expense of paying for the federal health care system, which serves people 65 and older and will only become more expensive as baby boomers retire.
Doctors say they are being squeezed between paying for office expenses that rise with inflation and Medicare rates that have remained flat for years and now face steep cuts.
Between the cut that takes place Dec. 1 and another cut set for Jan. 1, the combined result is a 30 percent reduction in doctor reimbursement rates, according to the medical society. In Connecticut, the cuts affect about 562,000 Medicare patients and 50,992 members of the military and their families in the Tricare program.
At Mansfield Family Practice in the northeast quadrant of the state, the five-doctor practice stopped accepting new Medicare patients in early 2010, partly because of low Medicare reimbursement rates.
"There are no other doctors in my area that I know of that are accepting new [Medicare] patients," said Ayaz Madraswalla, a family practitioner at Mansfield Family Practice. "And these are the sickest of the sick."
Another concern is how the reduction in Medicare rates will affect the way private health insurance companies pay doctors. Private insurers often pay more than the federal program, but the rate for a procedure is a percentage of Medicare reimbursement, such as 150 percent of Medicare.
Quinnipiac University business school professor Angela Mattie is skeptical that most doctors will limit access to care for Medicare patients for several reasons. The first is demographics; Medicare patients represent a large portion of the total patient population, which is especially true for cardiologists or other specialists who primarily treat people 65 and older.
Mattie also believes that the doctor-patient relationship as well as physician ethics will motivate doctors to continue accepting Medicare patients. But she agrees that ethics and doctor-patient relationships are up against the difficulties of running a small business on flat or reduced revenues.
Medical society president David S. Katz said, "Just because 94 percent of Connecticut physicians participate in the Medicare program doesn't mean that every patient has access to the care they need right now. Many physicians already limit the appointment slots for Medicare and Tricare patients. If Congress doesn't do something, this is only going to get worse."
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