What’s the Risk of Losing Access to Your Doctor?
Jun 08 2010
The big fear about the looming 21% cut in Medicare and TRICARE payments to doctors is that doctors will stop seeing patients using those programs.
Many already are running into access problems, and the fear is that any significant payment cut could make that situation much worse.
So far, the vast majority of MOAA members haven’t experienced access problems. Our surveys have indicated that 85% or more report no problems.
But that’s no help to the 15% who say they’ve had trouble finding a doctor to see them.
According to Medicare, the number of doctors who take Medicare patients actually rose last year — to 97.1%, vs 96% last year. But that doesn’t mean they’re all accepting new Medicare patients, just that they’re seeing at least some.
According to the Medicare Payment Advisory Commission, people under 65 report greater access problems than those 65 and over. Some claim that doctors can’t afford to stop seeing Medicare patients, because they comprise such a large share of their caseload (and income).
On the other hand, the AMA says its surveys show that 17% of providers already are limiting the number of Medicare patients they see because of low payment rates and worries over further cuts.
Does MOAA believe Congress will actually let a 21% payment cut go permanently into effect? Not a chance.
But the realities of health care and budget politics will probably keep us all on the hook for a while…maybe until after the November election.
In the meantime, there’s not much that will upset people more than a persistent threat that their health care could be disrupted — regardless of patients’ present experience.
Congress will do well to pay attention to the public’s growing worries on that topic.
9 Responses to “What’s the Risk of Losing Access to Your Doctor?”
Perhaps we military retirees are worrying too much about the Medicare cuts. Retirees who are eligible for Medicare B are also likely entitled to TriCare for Life. If Med B is your primary carrier and TriCare is the backup, it seems to me that a 21% cut in Medicare reimbursements simply shifts that amount over to TriCare, so Congress might not be doing us any favors, but are they doing us any harm?
I fear that one of my doctors will stop seeing me. He has already cut my visits to four annually.
I will keep on my representative’s back to see how he acts on this problem, and remember him in November should he not act on our behalf.
I have already been notified by my cardiologist that because of poor Medicare/Tricare coverage, my access will be extremely limited. They did not go so far as to deny appointments, just that I may have to wait longer (several months) unless I pick up another insurance coverage.
Family Practice doc has a form she wants me to sign with every visit stating I will personally be responsible for any short fall from Medicare/Tricare coverage. Thought this was against the rules, but my only choice is to sign or go elsewhere.
Even before the proposed 21% cut, my providers were not happy with the payments.
Some WA state providers are leaving the state because of low reimbursement.
My wife has had to change doctors twice in the last four years under TRICARE because of the low payments for services. Her first doctor did not want to take her on because in his words “TRICARE just doesn’t pay anything”. But after finding that she did not have any health issues he agreed to see her. Then he dropped his office practice and she had to see the doctor who took over his practice. Last year, he dropped out of TRICARE after two years and my wife had to seek another doctor. There are very few doctors in our area that accept TRICARE and until my wife becomes elgible for Medicare, we are concerned about her health care. Of course now with the cuts affecting Medicare, the future is even more uncertain. I bet if members of Congress were under the same health care programs as we are, there would not be a problem.
Our doctor of 15 years has already sent us a letter saying she is no longer accepting Tricare patients. And, yes…it was difficult to find another doctor in our part of Denver who does take Tricare. Not all on the Triwest site who say they’re accepting new patients are actually doing that. It will only get worse.
LTC Joe Putnam
My understanding is that TFL will be affected by the 21% cut. As I understand it TFL payments are based on what Medicare authorizes. So if Medicare is decreased, TFL will pay there normal percentage based on the lower Medicare payment. Just as supplements are based on Medicare. So it’s a lose, lose case.
We moved to Western Washington 3 years ago. For the first two years we had to see a FP doctor who commuted from Canada because she was the only FP/Internist accepting new Tricare patients. The only other option was the “free” clinic. Once a new health service provider came to town, we had to wait a year before one of the doctors would take us on. Comment “Tricare doesn’t really cover our costs.”
The constant efforts of the government to control costs by applying one solution fits all has generated a atrocious situation for those who actually served their country – the military. Unlike others who serve in congress etc who never really take any risks or loose any freedoms (we could not quit at any time, choose where we were sent, establish roots etc.) we are now offered substandard medical programs while they continue to have access to premier unlimited care. Here in the Hampton Roads area where I am in tricare prime it turns out that for gastrointestinal care there is only ONE physician who choses to participate in Tricare Prime. The interesting thing is there many other GI doctors who take Medicare and even Tricare Standard but not Tricare Prime – so much for PRIME it maybe should be called Tricare Suboptimal. Other specialties are equally limited. Oh! in case you may think this is just sour grapes, I work in the Naval Hospital Portsmouth in Radiology as a clinical medical physicist and have been in the health care field for over 40 years so I am not unfamiliar with the medical environment. If I sound angry, I am.
actually, TFL payment is limited by what Medicare will pay. TFL pays the Medicare 20% copayment. So if the Medicare limit is lowered, what TFL pays is lowered, too.
For example, if Medicare now allows $100, it pays 80% of that and TFL pays the other $20. If Medicare payments are cut 20%, Medicare would allow $80, pay 80% of that ($64) and TFL would pay the other $16.