"Doc Fix" process driving physicians out of Medicare

A Washington DC-based policy group contends a growing number of physicians are battling challenges and leaving the Medicare. The flight from the health care program is due toDoc Fix a process entitled “Doc Fix.”

According to the National Center for Public Policy Research doctors face serious financial risk with Medicare patients.A 2010 American Medical Association survey found that over three-quarters of the physicians who limit the Medicare patients they see cited the “ongoing threat of future payment cut makes Medicare an unreliable payer” as a reason.

In an a new National Policy Analysis paper entitled To Bring Doctors Back to Medicare, Fix The ‘Doc Fix’, Dr. David Hogberg, senior fellow with the National Center for Public Policy Research, argues that it is time to end the threat of physician cuts.

“One of the problems with this is that physicians fees have continued to grow and grow,” said Hogberg. “The difference between what Medicare spends each year on physician fees and the threshold set up by the sustainable growth rate as widened. So, if the cuts were to take place now, they would be huge.”

Hogberg says in January Medicare expects a temporary suspension to end which means physician fees will be cut by 25 percent. – which he calls the “doc fix” process.

“The affect this has had on physicians is to create a lot of uncertainty and worry,” said Hogberg. “If a third of your patients are on Medicare and in a few months Medicare is threatening to cut the fees it pays you to treat them by 25% – you could see a major hit in your income.”

The number of doctors who have stopped seeing Medicare patients has risen from 10 percent 12 years ago to 17 percent.

“Congress will undoubtedly suspend it,” added Hogberg. “But the problem is that this creates uncertainty among physicians. As a result, more and more physicians are limiting their exposure to Medicare. This is a big factor in helping to drive doctors away from Medicare.”

By 2030, the number of Medicare patients will increase 50 percent above present levels. “We need more physicians taking Medicare patients, not fewer,” notes Dr. Hogberg. “Ending the SGR is a good first step.