60% Of Physicians Would Limit Number Of New Medicare Patients If Scheduled Payment Cut Is Enacted, AMA Survey Finds

Main Category: Medicare / Medicaid / SCHIP
Article Date: 07 Jun 2007 - 16:00 PDT


The American Medical Association on Monday launched a $2 million lobbying campaign against a scheduled 10% cut in Medicare reimbursements to physicians, CQ HealthBeat reports. The cut is scheduled to take effect on Jan. 1, 2008, in accordance with the Medicare physician payment formula known as the sustainable growth rate (Armstrong, CQ HealthBeat, 6/4). Congress has blocked scheduled SGR cuts each year since 2002.

As part of AMA's campaign, the group released a survey of nearly 9,000 doctors showing that if the payment cut went into effect:

• 60% of doctors would limit the number of new Medicare patients they accept;
  
  
• More than two-thirds would defer the purchase of needed information technology in 2008;
  
  
• 50% would reduce their staff; and
  
  
• 14% would stop treating patients entirely.
  

According to AMA, scheduled SGR adjustments over the next nine years would amount to a 40% reduction in payments, while doctors' costs are expected to increase 20% during the same period (Lipman, Atlanta Journal-Constitution, 6/5). In addition to asking for a reversal of the scheduled 10% cut, AMA is lobbying Congress to eliminate the SGR formula. According to AMA, the cost of reversing future physician reimbursement cuts could be offset by making payments to private Medicare Advantage plans -- which currently are 12% higher on average than traditional Medicare payments -- equal to reimbursements for traditional Medicare (Johnson, CongressDaily, 6/5).

In the AMA survey, fewer than one in five doctors said that the additional payments to Medicare Advantage plans should continue. The Medicare Payment Advisory Commission in March issued a report recommending that Congress cancel the scheduled cut for 2008 and instead increase payments by 1.7% (Atlanta Journal-Constitution, 6/5). AMA supports the 1.7% increase (CongressDaily, 6/5).

AMA Comments
Cecil Wilson, chair of AMA's board, said the association "is deeply concerned by the alarming news" of the doctors' responses to the survey (Atlanta Journal-Constitution, 6/5). Discussing AMA's position on Medicare Advantage funding, Wilson said, "It doesn't make sense to cut in traditional Medicare in order to fund Medicare Advantage plans. Better to share that money equally." Wilson said that reducing Medicare Advantage payments by 12% would raise about $65 billion over five years -- roughly the same amount needed to keep Medicare physician reimbursements at current levels, with inflation adjustments, for five years (CongressDaily, 6/5).

"Every year for the last five years we've come to the night before the end of the year and Congress has stepped in and done something," Wilson said, adding, "We're suggesting that doing this year after year is an exercise in futility and certainly is frustrating everyone, and we're asking Congress to do something more long term this year."

SGR Change Unlikely
A permanent reform of the SGR formula is "not likely" this year "unless lawmakers have a significant change of heart," CQ HealthBeat reports. Senate Finance Committee Chair Max Baucus (D-Mont.) in February said, "I think we're still at the point where we have to deal with this on a yearly basis. I think we're going to get there, but I don't think this year" (CQ HealthBeat, 6/5). House Ways and Means Health Subcommittee Chair Pete Stark (D-Calif.) also has indicated that he does not expect a permanent SGR reform to be implemented this year (Atlanta Journal-Constitution, 6/5).

"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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