Fewer physicians accepting Medicare due to low reimbursements

[axeman462]

"Medicare reimbursement rates for physicians have been relatively flat for about 20 years, but last year saw a two percent decrease. They decreased another 3.4 percent this year until the latest budget Congress passed mitigated some of that, but the decrease will still be about 1.7 percent."
“Every time you see a Medicare patient, you lose money, so we’re just trying to lose less money per patient,” he said.

"In a point-in-time survey to their members, of the 161 primary care physicians to respond, only 31 are accepting new Medicare patients."

[EXTERNAL LINK] - Fewer physicians accepting Medicare due to low reimbursements

 

[Russ]

Medicare and MA's headed in the wrong direction. There's an ending point to all this. May not be what insurance agents want.

 

[axeman462]

Medicare and MA's headed in the wrong direction. There's an ending point to all this. May not be what insurance agents want.

 

[ValeRosso]

I wonder what the Medicare reimbursement rates vs MAPD reimbursement rates look like

 

[axeman462]

I wonder what the Medicare reimbursement rates vs MAPD reimbursement rates look like

this is copied from a post I did a few months back, I talked to a doctor's office recently who is not accepting new OM patients anymore. This was the data they gave me:

• Physician payments from Original Medicare have not kept up with inflation over the past 20 years, and it is getting harder for many doctor offices to keep the doors open.
• This particular office gave me a few specific examples:
  • Florida Blue 2023
    • $94,300 in charges, $73,500 in receipts, $20,800 in adjustments.
    • She says they are making an average of 23cents on every dollar of receipts
  • UHC 2023
    • $155,000 in charges, $124,000 in receipts, $31,000 in adjustments
    • They make an average of 38cents on every dollar of receipts
  • Original Medicare
    
    • $260,000 in charges, $163,800 in receipts, $96,200 in adjustments
    • They lose 31 cents on every dollar of receipts due to overhead related to OM regulations
• The extra red tape from Medicare causes the physicians to spend less time with the patient, and therefore, lower quality healthcare. It is the doctor's wish to provide only the highest quality service to the patients.

 

[rmhaire]

I wonder what the Medicare reimbursement rates vs MAPD reimbursement rates look like

Here's an article from 2017 that had things pretty much equal. Things haven't change that much in the past 7 years.

Medicare, Medicare Advantage Physician Reimbursement Rates Nearly Equal

USC researchers compare physician reimbursement by Medicare Advantage plans to traditional Medicare rates. Until now, experts knew little about the differences

healthpolicy.usc.edu