The Medicare Insured: Worth the Hassle?

moneyAs healthcare providers, we have all dealt with the many hoops we have to jump through in order to get reimbursed for Medicare patients. There are the hundreds of regulations  which call for our compliance, not to mention the many cuts in the program. At a point we have all reasoned the worth of taking these patients. Do we stay in or opt out?

Although all providers can be affected by Medicare, let us take a look at physicians specifically. According to the Centers for Medicare and Medicaid Services (CMS), 9,539 physicians who had accepted Medicare opted out of the program in 2012, which was up from 3,700 in 2009. What does this tell us? Physicians are growing increasingly unhappy with the ever changing system that is Medicare.

The biggest issue at hand is bankruptcy. Will taking Medicare patients make me close my practice? With increasing healthcare costs and decreased reimbursements, physicians with practices are concerned that they will not be able to stay afloat. Thus, the norm has been to limit the amount of Medicare patients or new Medicare patients that are taken on. According to a study by the American Academy of Family Physicians of 800 members, family physicians who take new Medicare patients decreased from 83 percent in 2010 to 81 percent.

Another option physicians have taken is to opt out of the Medicare program all together. A growing trend is that of concierge practices where the patient pays an annual fee  or retainer for more personal services. In the same study by the American Academy of Family Physicians,  4 percent of family physicians are now in cash-only or concierge practices.

So why stay in at all? Most physicians stay in the program because they feel an ethical responsibility to do so. Who wants to say no to an elderly woman requiring your care?

With Obamacare coming into full effect in the next year, Medicare participation is a huge concern. The baby boomers are coming of age and limiting their care seems to be a huge possibility. Physicians all have a right to decide what is best for their practice. In truth, it is a business. But, patient care should always be regarded as the number one priority and it would be irresponsible not to keep it as such.

Have you found other ways to keep your Medicare patients?