Private practice docs are cutting off Medicare patients
The old model of a single doc running a practice is disappearing in America. Between the overhead and the reduced compensation, this model of health care delivery looks increasingly anachronistic.
When I started as an assistant professor at a medical school in 1987, there was a lot of money sloshing around. Patients and their insurance companies would pay a premium to be seen by docs in an academic health care practice. Managed care put an end to that, and the medical school from which I recently retired is struggling to stay in the black after many years of deficits.
At the other end of the food chain are private practice docs. As America ages, more and more of their patients are on Medicare (as am I). And the government is proposing to slash Medicare payments again. The only way to weather these cuts is through joining group practices, which can achieve an economy of scale.
“Will his independent practice be able to survive another Medicare payment cut? That’s what Terre Haute, Indiana internist Pardeep Kumar, MD, wonders each day as the next round of cuts looms.
“We have to see,” Kumar said in a phone interview. “We have around 40% of the population of patients that are on Medicare … Our overall ability to sustain as a private practitioner is significantly under distress because of these cuts.”
*snip*
“CMS is proposing a 2.8% cut in the Medicare fee schedule for the 2025 fiscal year, which would, if approved by Congress, come on top of a 1.69% cut in 2024. Often, Congress reverses the cuts, although this year they did so only partially. The cut is currently in limbo — along with the rest of the federal budget — now that Congress has passed a short-term budget deal keeping the government funded at current levels through mid-December, after the election.”
Our current model of healthcare in America is increasingly unsustainable. When will the physician community wake up to the reality of single payer, a model used by all the other industrialized nations on the planet? Meanwhile, people on Medicare struggle to find primary care physicians.
private practice docs struggle with Medicare
When I started as an assistant professor at a medical school in 1987, there was a lot of money sloshing around. Patients and their insurance companies would pay a premium to be seen by docs in an academic health care practice. Managed care put an end to that, and the medical school from which I recently retired is struggling to stay in the black after many years of deficits.
At the other end of the food chain are private practice docs. As America ages, more and more of their patients are on Medicare (as am I). And the government is proposing to slash Medicare payments again. The only way to weather these cuts is through joining group practices, which can achieve an economy of scale.
“Will his independent practice be able to survive another Medicare payment cut? That’s what Terre Haute, Indiana internist Pardeep Kumar, MD, wonders each day as the next round of cuts looms.
“We have to see,” Kumar said in a phone interview. “We have around 40% of the population of patients that are on Medicare … Our overall ability to sustain as a private practitioner is significantly under distress because of these cuts.”
*snip*
“CMS is proposing a 2.8% cut in the Medicare fee schedule for the 2025 fiscal year, which would, if approved by Congress, come on top of a 1.69% cut in 2024. Often, Congress reverses the cuts, although this year they did so only partially. The cut is currently in limbo — along with the rest of the federal budget — now that Congress has passed a short-term budget deal keeping the government funded at current levels through mid-December, after the election.”
Our current model of healthcare in America is increasingly unsustainable. When will the physician community wake up to the reality of single payer, a model used by all the other industrialized nations on the planet? Meanwhile, people on Medicare struggle to find primary care physicians.
private practice docs struggle with Medicare
Joel:
I agree there are problems arising from the cuts. There is a history going back father than this recent cut and a proposed cut. Just have to look at it again to give more detail.
I believe there are other issues adding to the costs of healthcare unrelated to Labor which need to be looked at more closely. I will be back at this later. Never got to post on this issue. Glad you took it up.
Boiled down to ones and zeros: perhaps if ‘medicine’ weren’t ‘for profit’
No disrespect to those in the industry, I am on the periphery, but between ‘insurance’ and the drug companies it is Big Business. What’s good for General Motors is good for the USA …
@Ten,
All the industrialized nations on the planet do a better job of insuring their citizens for half the cost.
or less. saw video of a UK ER doctor looking at costs of drugs etc in the US VS the UK. Saline for example was about $8 in the UK, in the US, its about$100 for the same amount. they were stunned.
cant forget that a lot of independent doctors offices are getting bought up private equity, and add on their buying ERs in hospitals, leading to lower care and more stress on providers (doctors must complete their exams ETC in 10-15 mins, which can lead to snap judgements. we have a friend in Tucson, Arizona that was in so much pain that they had to crawl into their PCP, and were made fun of. later they went to the ER, where they got pain killers (seems they have hurt their back ) after the ER shared their results with their PCP the PCP was very…accommodating sort of. i think they fired that PCP, and went with another, and had a round of conversations with numerologists, surgeons, and others trying to resolve the problem. they have had several surgeries, and still have lots of pain (even with lots of pain meds) . after one surgery they were sent to a recovery center, where they were ignored as they needed more pain medicine (seems that they weren’t getting what was ordered. they called my wife and she tried to help (we are in Texas which makes it hard to help). in the end they called 911, cause they didnt get help they needed. surgeon wasnt happy, wasnt their fault, hospital wasnt either, but they did get the help they needed. suspect that was a staffing issue.
Locally, in the Chicago area, a number of doctors have announced they are no longer taking medicare patients and then changing their minds when they realized that that is where “the market” is and there aren’t enough affluent private pay patients to support them as a group but only a few particularly sought after providers.
Jack:
Medicaid and VA are similar to what you are saying too. Medicaid maybe. The others not so easy. Be in the area Dec3 to the Dec 9.
Stop by. The coffee pot still works.