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Citing SGR Cuts, Physicians Mull Dropping Medicare Patients

 |  By John Commins  
   October 26, 2010

Two of three medical practices surveyed—67% of respondents—say they will either limit the number of new Medicare patients they accept or stop seeing Medicare patients altogether if Congress does not halt reimbursement cuts of about 30% that take effect by the end of the year, a survey by the Medical Group Management Association shows. 

A reimbursement cut of 23.6% is slated to take effect Dec. 1, followed by an additional 6.5% cut on Jan. 1, as part of the Medicare's controversial sustainable growth rate formula.

The SGR formula has called for an across-the-board reduction in physician payment rates every year since 2002, and since 2003, through May 31, 2010, the cuts have been averted by legislative action.

"This is a situation that must be dealt with immediately when Congress returns after the elections," said MGMA President/CEO William F. Jessee, MD in a statement. "Further congressional delays jeopardize patients and the medical practices that serve them."

If no action is taken to stop the reductions, 49.5% of medical groups said that they will stop seeing new Medicare patients, and 27.5% of respondents said they would cease treating Medicare patients. 
In addition, physician practices are considering other steps to address reimbursement cuts:

  • 76% will likely delay the purchase of new clinical equipment and/or facilities;
  • 60% will likely reduce the number of administrative support staff;
  • 54% will likely reduce clinical staff; and 
  • 45% will likely delay purchase of electronic health records systems        

Nearly 30% of practices began reducing the number of appointments for new Medicare patients last spring when Congress failed to avert Medicare payment cuts by the June 1 deadline. Congress temporarily delayed the cuts retroactively.

MGMA's survey shows the uncertainty created by the retroactive legislation has already triggered:

 

  • 37% delayed purchasing electronic health records systems;
  • 32% reduced administrative staff; and
  • 27.5% reduced clinical staff

"The concrete actions already taken by medical groups as a result of the uncertainty created by congressional inaction have added significant barriers to quality care," Jessee said. 

"Uncertainty about the future is creating an unsustainable environment for many who practice in areas with large Medicare populations."

Jessee called on Congress to block the cuts and provide an updated SGR that lasts, at a minimum, through the end of 2011. "This will provide lawmakers and the provider community time to develop a long-term solution that ensures beneficiaries have continued access to quality care," he said.

MGMA conducted its SGR survey from mid-September to mid-October, and received responses from more than 2,860 practices where 63,000 physicians practice.

John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.

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