California Healthline: More Doctors Are Quitting Medicare. Is Obamacare Really To Blame?

by Dan Diamond, California Healthline Contributing EditorWednesday, August 7, 2013

“Half of primary care physicians in survey would leave medicine … if they had an alternative.” — CNN, November 2008

“Doctors are increasingly leaving the Medicare program given its unpredictable funding.” — ForbesJanuary 2013

Doctors, it seems, love medicine so much … that they’re always threatening to quit.

In some cases, it’s all in how the question is asked. (Because of methodology, several eye-catching surveys have since been discredited.)

But physicians’ mounting frustration is a very real problem, one that gets to the heart of how health care is delivered and paid for. Is the Affordable Care Act helping or hurting? The evidence is mixed.

Doctors’ Thoughts on Medicare: Not as Dire as Originally Reported

The Wall Street Journal last month portrayed physician unhappiness with Medicare as a burning issue, with a cover story that detailed why many more doctors are opting out of the program.

And yes, the number of doctors saying no to Medicare has proportionately risen quite a bit — from 3,700 doctors in 2009 to 9,539 in 2012. (And in some cases, Obamacare has been a convenient scapegoat.)

But that’s only part of the story.

What the Journal didn’t report is that, per CMS, the number of physicians who agreed to acceptMedicare patients continues to grow year-over-year, from 705,568 in 2012 to 735,041 in 2013.

And other providers aren’t turning down Medicare, either. The number of nurse practitioners participating in the program has only gone up, Jan Towers of the American Academy of Nurse Practitioners told California Healthline.

That’s not to overlook doctors’ feelings about the program; “the reality is that Medicare has caused some very real frustration,” according to Reid Blackwelder, president-elect of the American Academy of Family Physicians.

But that frustration isn’t new, Blackwelder told California Healthline; the “tipping point was 2003” — when Medicare’s much-maligned Sustainable Growth Rate to calculate physician payments began to kick in — “and it’s been an ongoing stressor since,” with temporary patches that can lead to uneven reimbursement.

And actually choosing to opt out is still a big leap for many doctors, given that the program represents so many potential procedures; Medicare patients make up 24% of the patient population for AAFP members, Blackwelder says.

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