It’s that kind of agony that keeps Dr. Jane Orient, a general internist in Tucson, Ariz., from participating in Medicare. Dr. Orient opted out of the program in 1990, around the time that Medicare began requiring that physicians file claims for payment. Previously, patients could pay her directly for services and be reimbursed by Medicare.
“I decided I just could not do that,” said Dr. Orient, executive director of the Association of American Physicians and Surgeons. “For me to file the claim and figure out what all those E&M guidelines meant, was just impossible. I certainly couldn’t do it with the staff I had.”
Rep. Michael C. Burgess
The fundamental problem, said Rep. Michael C. Burgess (R-Texas), cochair of the Congressional Health Caucus and an ob.gyn., is that patients get their care covered at a price they can afford, while Medicare’s payment to physicians doesn’t cover the cost of care.
“What has always been a bad situation is getting worse and worse with every passing year,” Rep. Burgess said.
Rep. Phil Roe (R-Tenn.), cochair of the GOP Doctors Caucus, said the problem for lawmakers is that they must fix the physician payment system before patient access is significantly affected. How much time do they have?
Rep. Roe, an ob.gyn., said physicians will hang on for as long as they can. But if Medicare continues to cut payments, an access crisis is coming.
If Medicare’s solution to their financing problem is to cut providers, he said, physicians will look for a way out of the program, and that will start with large-scale retirements of older physicians.
“They are all looking for the exit signs now,” Rep. Roe said.
